In accordance with Law No. 29733, Personal Data Protection Law and its Regulations, I declare that I have been informed and authorize that the personal data, related to me and the person whom I represent, recorded in this virtual form, as well as such as those obtained by virtue of my relationship with the University of Piura, (hereinafter THE UNIVERSITY), including my image, voice, signature, electronic signature and/or fingerprints, are stored in the Data Banks of THE UNIVERSITY or others that comply with the security measures required by the regulations on the matter; and are processed by THE UNIVERSITY and/or by natural and/or legal persons whom it delegates or entrusts; who may process said data for the following purposes:

1. 1. for the execution of the relationship with the data owner
   2. to manage response processes to claims and/or complaints.
   3. to comply with the requirements of consumer protection regulations.

I hereby state that THE UNIVERSITY guarantees the possibility that I have to exercise the rights of access, rectification, cancellation and opposition, and any other rights provided, in accordance with the regulations of the matter, requesting it in writing at the following address: Av. Ramón Mugica 131, Urb. San Eduardo, Piura or email: datapersonalesudep@udep.edu.pe.

The contact information for the University of Piura can be found at www.udep.edu.pe.

Consequently, I hereby authorize THE UNIVERSITY to carry out the aforementioned activities.