CONSENT 
to the processing of personal data

I,_________________________________________________________________________
(surname, name, patronymic)
(born on ____ ____________ 19___, passport series ______ No. ____________,
issued  ___________________by __________________________________________________), 
in accordance with the Law of Ukraine “On Protection of Personal Data”, and in order to ensure the consideration and processing of documents and information regarding me in connection with the selection for the positions of independent members of the supervisory board of the joint-stock company “Dniprovs`ka combine heat power plant”, also in order to maintaining a database of personal data, preparing in accordance with the legislation requirements statistical, administrative and other information on appointment of officials of bodies of the state sector of economy entities, hereby give my consent to the following:
processing my personal data taken from primary sources, in particular, the information about education, profession, specialization and qualification, academic degree and status, professional development, passport data, information about awards, income declarations, financial obligations, property status, autobiographical data, career information and work experience, professional competencies, personal data (age, gender, family status, family members etc.), the information about the registered or actual place of residence, registration on the military records, health data within the limits established by law, the vacation period, the right to benefits established by law, the registration as a natural person in the State Register of Natural Persons – Taxpayers, identification data in the electronic format (Curriculum vitae, telephone numbers), recorded images (photos);
the use of my personal data that envisions any actions of the possessor of the personal data to process and protect such data as well as the actions related to the grant of a partial or full right to process my personal data to other parties to a relationship in connection with my personal data that are carried out subject to consent by the subject of the personal data or in accordance with law (Article 10 of the said Law);
disclosure of my personal data that envisions some actions related to the transfer of information about a natural person subject to consent by the subject of the personal data (Article 14 of the said Law);
access to my personal data by third persons that is carried out in accordance with the present Consent or in accordance with law;
In the case of change in my personal data, I hereby undertake to provide accurate and fair information and original copies of the relevant documents as soon as possible to update my personal data.
On the processing of personal data, as any action or set of actions, such as collection, registration, accumulation, storage, adaptation, modification, renewal, use and distribution (dissemination, realization, transmission), depersonalization, destruction of personal data, including using informational (automated) systems, informed.
On the rights and obligations of the subject of personal data, the owner and the manager of personal data and other participants of such legal relations in accordance with the Law of Ukraine "On Protection of Personal Data" is informed.

_____   ____________   20____                                                                   _________________
                                                                                                                               (signature)