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1. Title and Date: Clear identification of the document as an Interview Consent Form with the date of execution

2. Parties: Identification of the interviewer/research organization and the interviewee, including complete names and contact information

3. Purpose of the Interview: Clear explanation of the interview's purpose, its context, and how the information will be used

4. Interview Procedures: Description of what the interview will involve, including duration, format, and type of questions

5. Data Privacy and Confidentiality: Explanation of how personal information will be collected, used, stored, and protected in compliance with the Data Privacy Act

6. Voluntary Participation: Statement confirming that participation is voluntary and can be withdrawn at any time

7. Rights of the Interviewee: Clear outline of the interviewee's rights, including right to refuse questions and withdraw consent

8. Declaration and Signatures: Formal declaration of consent and space for signatures of all parties

1. Interview Questions Overview: General outline of interview topics or sample questions, helping interviewee understand the scope

2. Data Privacy Notice: Detailed privacy notice as required by the Data Privacy Act of 2012, explaining data handling practices

3. Contact Information Sheet: Separate sheet with contact details of relevant parties (interviewer, supervisor, data protection officer)

4. Withdrawal Form: Template form for withdrawing consent, ensuring clear process for exercising this right