CONSENT FORM FOR COMMUNICATION AND ELECTRONIC SENDING OF INVOICES

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Unique ID

To:
District Local Government Organization of Larnaka (“DLGOL”)

1. I, the undersigned, hereby provide my consent to the DLGOL to communicate with me as declared and for the purposes stated in the present form.

2. Premises details (Address)

3. Personal information / Contact details:

Name*

Identity No.*

Mobile phone number

E-mail*

4. Water Supply Issues
I declare that I wish to receive my water bills as well as any information on water supply issues as follows:

I. Water Bills:

ONLY via e-mail.

II. Newsletters regarding my bill as well as any information on water supply issues:

via e-mail.

via mobile phone.

Sewerage Issues
I declare that I wish to receive my sewerage bills as well as any information on sewerage issues as follows:

I. Water Bills:

ONLY via e-mail.

II. I declare that I wish to receive my sewerage bills as well as any information on sewerage issues as follows:

via e-mail.

via mobile phone.

5. I also undertake to inform the DLGOL in the event of any change to the above contact details.

6. I have been informed that the DLGOL is not liable if for any reason I do not receive my bill and/or I am not informed either regarding my account or for any other matter which is covered by this consent form. I am also aware that non-receipt of my bill does not constitute a reason for non-payment of my bill within the time-period specified by the DLGOL. Furthermore, if I am not informed by the DLGOL and/or if for any reason, information is not brought to my attention regarding any water supply and/or sewerage issue, which may cause damage to my property, the DLGOL bears no responsibility.

7. I acknowledge that with the present form I provide my consent to the processing of my personal data from the DLGOL, as they appear in paragraph 3 above, for the purposes referred to in paragraph 4 above. I understand that the DLGOL processes my personal data in the context of providing its services under the District Local Government Organizations Law of 2022 (Law 37(I)/2022) and the applicable Regulations, as amended or replaced from time to time (article 6(1)(c) of Regulation (EU) 2016/679), as well as for the purposes of the legitimate interests pursued by the DLGOL and more specifically for the purposes of communicating with the people to which it provides its services and for purposes of more efficient provision of its services (article 6(1)(f) of Regulation (EU) 2016/679). Any processing is carried out in accordance with Law 125(I)/2018 and the General Data Protection Regulation (EU) 2016/679. I am aware that I have the following rights with regard to my personal data, subject to the provisions of Regulation (EU) 2016/679: right to be informed, right of access, right to rectification, right to erasure, right to restriction of processing, right to data portability, right to object to the processing, right to not be subject to automated individual decision-making and the right to submit a complaint to the Office of the Commissioner for Personal Data Protection. I am also aware that I have the right to withdraw my consent at any time and such withdrawal of consent shall not affect the lawfulness of processing based on consent before its withdrawal. The period during which the DLGOL will process my personal data is the period for which the DLGOL provides services and/or imposes fees, in accordance with the Law. I am aware that for more information on the processing of my personal data from the DLGOL, I can visit the Personal Data Protection Policy which is posted on the website of the DLGOL (www.eoal.org.cy) or I can contact the Data Protection Officer of the DLGOL (Address: Adamantiou Korai 12, 6010 Larnaka, Cyprus, e-mail: dpo@eoal.org.cy).

Signature*

Date*

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