I, on behalf and representation of , with CIF (fiscal number) , and address . MANIFESTS to have been informed expressly, accurately and unequivocally, in accordance with the provisions of Organic Law 15/1999, of December 13, on the Protection of Personal Data, of the following:
Such consent shall be deemed to have been provided as long as it is not communicated otherwise in writing. The acceptance so that the data can be processed or transferred in the terms established herein, has been, in accordance with the provisions of Articles 6 and 11 of the Organic Law 15/1999, of December 13, of revocable character and without retroactive effects. I sign the present on . Signature: