Ime i prezime podnositelja zahtjeva Broj identifikacijskog dokumenta Email adresa Broj telefona Naziv poduzeća Razlog posjete Datum posjete Vrijeme posjete Detalji o posjetiocima: Najviše 18 posjetioca Br. Ime Broj identifikacijskog dokumenta Kontakt broj Email adresa PODNOSITELJ/ICA ZAHTJEVA POTVRĐUJE DA JE OBAVEŠTEN/A O ISPOD NAPISANIM PROPISIMA I DA SE OBVEZUJE PRIDRŽAVANJU ISTIH DAVANJEM NJEGOVOG/NJEZINOG POTPISA DOLJE. Potpiši iznad Pročitao/la sam i slažem se sa AGCT Security & Safety Regulations. AGCT SECURITY & SAFETY REGULATIONS 1. Pri ulasku predočite osobni dokument. 2. Sigurnosne provjere mogu se provesti na bilo kojem mjestu unutar terminala. 3. Samo osobe navedene na obrascu za posjetitelje smiju ući u terminal osim ako se novi obrazac popuni i preda prije zakazanog posjeta. 4. Osobe pod utjecajem alkohola i/ili droga neće smjeti ući u terminal. 5. Nošenje smrtonosnog oružja nije dopušteno. 6. Nosite propusnicu za posjetitelje na vidljivom mjestu dok ste unutar terminala. 7. U slučaju kašnjenja ili bilo kakvih promjena u traženom posjetu, koordinator posjeta mora se službeno obavijestiti. Pristajem dati svoje osobne podatke na obradu u skladu sa ICTSI Legal Form Consent. CONSENT To Processing of Personal Information Being a/an applicant, customer or supplier of, or any other third party transacting or dealing with, INTERNATIONAL CONTAINER TERMINAL SERVICES, INC. (“ICTSI”), and/or any of the ICTSI subsidiaries, affiliates, and other related companies (the “ICTSI Group”), affirm that: ICTSI and the ICTSI Group may process information about me in relation to my position. Information processed may include: name, marital status, Tax Identification Number, age, address, education, profession, business experience, business affiliation, family affiliation, number of shareholdings, directorship in other companies, government service, any information from which identity of an individual is apparent or can be reasonably and directly ascertained, whether recorded in material form or not, such as CCTV footages and recordings within ICTSI and ICTSI Group premises and other information which may be considered personal and sensitive personal information (collectively, “Personal Information”) under the Data Privacy Act of 2012. Processing is any operation performed on the Personal Information, such as, but not limited to, collection, retention, disclosure, publication and destruction (“Processing”). The Processing of my Personal Information is for purposes of: Identification in company records and corporate housekeeping; Corporate transactions and business operations; Compliance with the requirements, including reportorial obligations, by the Security and Exchange Commission (SEC), the Philippine Stock Exchange (PSE), Bureau of Internal Revenue (BIR), relevant local government units, and other appropriate government agencies or offices; Maintenance of security within and around the premises Compliance with legal processes or lawful orders of judicial and quasi-judicial bodies, or any other government agencies and instrumentalities; or Any other legitimate business activities of ICTSI. ICTSI and the ICTSI Group may share or disclose my Personal Information to: The SEC, PSE, BIR, relevant local government units, and other appropriate government agencies or offices; Any judicial and quasi-judicial bodies or government agencies pursuant to a lawful order; c) Any customer or port user; Any agent, contractor, consultant, adviser, auditor, underwriters or any service provider ICTSI engages to carry out legitimate business activities or services; Any lenders, creditors, or other counterparties in legitimate business transactions; or Any other persons as may otherwise be considered necessary and appropriate by ICTSI for its legitimate business activities. Those enumerated in Clause 3 above may also need to continue the Processing of my Personal Information for the same purposes enumerated in Clause 2 above and/or other lawful purposes. The Data Privacy Act of 2012 prohibits the Processing of Personal Information without the consent of the data subject, unless required by law. I hereby freely give this specific and informed consent for the Processing of my Personal Information in accordance with the above. This consent is valid while I am a/an applicant, customer or supplier of, or any other third party transacting or dealing with ICTSI. However, I understand that I can withdraw this consent anytime by informing ICTSI in writing.