Notice withdrawing consent to personal data processing — Worked input example

Withdraws specific consent for future processing and requests any retention basis without assuming automatic deletion of all data. Worked input example.

Key template information and options
What to clarify	Example or option on this page
How would you like to receive the response?	By email / By post / Through the official electronic channel
On whose behalf are you submitting the request?	About my own personal data / As a specifically authorised representative / As a statutory representative
Scope of the withdrawal of consent	All the specified consent / Purposes explicitly specified separately

Prepare information from this template’s actual fields. Your choices determine additional inputs; selecting an option does not establish authority, a right or an event.

Legal templates and their PDF/Word text are in Latvian. This is a completion guide, not a signed document or a legal opinion.

DEMONSTRATION — invented input examples. They are never inserted into your document and do not establish identity, payment, authority, rights or an event.

Information and checks before completion

Input field	What to prepare	Demonstration entry
Full name of the applicant signing the document	Enter the precise, verifiable information requested here; refer to evidence rather than giving unsupported assurances. Required when the field is active.	DEMO — enter the verifiable actual circumstances here.
Input field 2Exact field label in the Latvian editor: Iesniedzēja saziņas adrese	Enter the precise, verifiable information requested here; refer to evidence rather than giving unsupported assurances. Required when the field is active.	DEMO — enter the verifiable actual circumstances here.
Input field 3Exact field label in the Latvian editor: Iesniedzēja e-pasts atbildei	Enter the actual contact email of the relevant person. The field does not verify that email address. Not unconditionally marked as required; a particular choice may make it required.	demo@example.invalid — a non-working demonstration address
Data controller: organisation name or full name	Enter the precise, verifiable information requested here; refer to evidence rather than giving unsupported assurances. Required when the field is active.	DEMO — enter the verifiable actual circumstances here.
Input field 5Exact field label in the Latvian editor: Datu pārzinis: pārbaudīta adrese vai oficiālais saziņas kanāls	Enter the precise, verifiable information requested here; refer to evidence rather than giving unsupported assurances. Required when the field is active.	DEMO — enter the verifiable actual circumstances here.
Document preparation date	Choose the date that fits this field’s purpose. The document date, event date and receipt date are not automatically the same date. Required when the field is active.	2030-04-15 — format example only, not an actual date
How would you like to receive the response?	Choose one of the template’s actual options. Compare the additional requirements triggered by the choice. Required when the field is active.	No option is selected in this example; compare the available options below.
Exact official response channel	Describe the actual circumstances, a party’s obligation or the reference to evidence. Generic example text is not an actual agreed condition. Required when the field is active. Shown when you choose: How would you like to receive the response? = Through the official electronic channel.	DEMO — enter the verifiable actual circumstances here.
On whose behalf are you submitting the request?	Choose one of the template’s actual options. Compare the additional requirements triggered by the choice. Required when the field is active.	No option is selected in this example; compare the available options below.
Input field 10Exact field label in the Latvian editor: Pārstāvētā datu subjekta vārds un uzvārds	Enter the precise, verifiable information requested here; refer to evidence rather than giving unsupported assurances. Required when the field is active. Shown when you choose: On whose behalf are you submitting the request? = As a specifically authorised representative.	DEMO — enter the verifiable actual circumstances here.
Input field 11Exact field label in the Latvian editor: Likumiskās pārstāvības pamats un pierādījums	Describe the actual circumstances, a party’s obligation or the reference to evidence. Generic example text is not an actual agreed condition. Required when the field is active. Shown when you choose: On whose behalf are you submitting the request? = As a statutory representative.	DEMO — enter the verifiable actual circumstances here.
Input field 12Exact field label in the Latvian editor: Kāda piekrišana atsaukta?	Describe the actual circumstances, a party’s obligation or the reference to evidence. Generic example text is not an actual agreed condition. Required when the field is active.	DEMO — enter the verifiable actual circumstances here.
Input field 13Exact field label in the Latvian editor: Konkrētie nolūki un datu apjoms, uz ko attiecas atsaukums	Describe the actual circumstances, a party’s obligation or the reference to evidence. Generic example text is not an actual agreed condition. Required when the field is active.	DEMO — enter the verifiable actual circumstances here.
Scope of the withdrawal of consent	Choose one of the template’s actual options. Compare the additional requirements triggered by the choice. Required when the field is active.	No option is selected in this example; compare the available options below.
Input field 15Exact field label in the Latvian editor: Piekrišanas vai iepriekšējās saziņas pierādījums	Describe the actual circumstances, a party’s obligation or the reference to evidence. Generic example text is not an actual agreed condition. Not unconditionally marked as required; a particular choice may make it required.	DEMO — enter the verifiable actual circumstances here.
Which consequences for the service should be explained?	Describe the actual circumstances, a party’s obligation or the reference to evidence. Generic example text is not an actual agreed condition. Not unconditionally marked as required; a particular choice may make it required.	DEMO — enter the verifiable actual circumstances here.
Input field 17Exact field label in the Latvian editor: Esmu pārbaudījis faktus, prasījumu un pielikumu sarakstu.	Tick only after the required review. A tick is not approval by an external authority. Required when the field is active.	Do not tick this until you have checked the statement yourself.
Who does the data request concern?	Choose one of the template’s actual options. Compare the additional requirements triggered by the choice. Required when the field is active.	No option is selected in this example; compare the available options below.
Input field 19Exact field label in the Latvian editor: Pilnvarojuma pierādījums un konkrētais tiesību apjoms	Describe the actual circumstances, a party’s obligation or the reference to evidence. Generic example text is not an actual agreed condition. Required when the field is active. Shown when you choose: On whose behalf are you submitting the request? = As a specifically authorised representative.	DEMO — enter the verifiable actual circumstances here.
Full name of the data subject you represent under the law	Enter the precise, verifiable information requested here; refer to evidence rather than giving unsupported assurances. Required when the field is active. Shown when you choose: On whose behalf are you submitting the request? = As a statutory representative.	DEMO — enter the verifiable actual circumstances here.

Review the options and dependent fields

How would you like to receive the response?

Editor option	Which information changes
By email	This option additionally requires: Input field [Iesniedzēja e-pasts atbildei].
By post	The schema has no direct additional-field requirement for this option. Other document checks still apply.
Through the official electronic channel	This option displays: Exact official response channel. This option additionally requires: Exact official response channel.

On whose behalf are you submitting the request?

Editor option	Which information changes
About my own personal data	The schema has no direct additional-field requirement for this option. Other document checks still apply.
As a specifically authorised representative	This option displays: Input field [Pārstāvētā datu subjekta vārds un uzvārds]; Input field [Pilnvarojuma pierādījums un konkrētais tiesību apjoms]. This option additionally requires: Input field [Pārstāvētā datu subjekta vārds un uzvārds].
As a statutory representative	This option displays: Input field [Likumiskās pārstāvības pamats un pierādījums]; Full name of the data subject you represent under the law. This option additionally requires: Input field [Likumiskās pārstāvības pamats un pierādījums].

Scope of the withdrawal of consent

Editor option	Which information changes
All the specified consent	The schema has no direct additional-field requirement for this option. Other document checks still apply.
Purposes explicitly specified separately	The schema has no direct additional-field requirement for this option. Other document checks still apply.

Who does the data request concern?

Editor option	Which information changes
For data relating to an identifiable natural person	The schema has no direct additional-field requirement for this option. Other document checks still apply.
For the legal entity's own commercial information	The schema has no direct additional-field requirement for this option. Other document checks still apply.

Open the actual template →

Questions about completion

What should I prepare for this document?

Use the specific field list and option table. This template has 20 fields; 17 are required by the schema when active. Additional conditions may require other inputs.

Will demonstration values fill my document?

No. The example exists only in this public guide. Enter your actual information in the template; this page saves nothing and creates no document.

Can I submit a completed example immediately?

Not automatically. Check the actual parties, conditions, attachments, signing and submission procedure. A completed file is not a signature, proof of payment or an authority’s decision.

Sources already listed for this template

Sources come from this template’s published metadata; this guide does not certify a new legal review or fulfilment of every requirement.