The Request For Deletion (RFD) form comprises a single sheet of paper, two sides.
REQUEST FOR DELETION (RFD) In the interest of employee safety, our employees are required to wear uniforms equipped with protective media to discourage others from exposing them to dangerous situations or environments (e.g. establishments where fire exits are chained shut illegally or the like), or to falsely accuse our employees of crimes (such as shoplifting and the like). Our employee uniforms capture images, photometric measurements, and or other measurement information and the like, which may have been and may continue to be transmitted and recorded at remote locations. Furthermore, our employees are required to document, via more traditional photographic means, any incident in which there is a perceived or suspected safety hazard, or any incident in which there might be potential for a crime to be committed in the future (such as when an employee presents a company credit card, when an employee makes a purchase but is not given a receipt that provides proof of the purchase such that a false shoplifting accusation could be forthcoming, or when cash is being handled by one of our employees). For YOUR protection, our employees are also required to photograph each person they interact with, as well as maintain a recording of the conversation, in order to pre-empt any disputes regarding return of merchandise. If you feel that one of our employees has documented something within your establishment that you do not wish to have remaining on file in our image archives, or if you feel that your likeness should not remain on file in our archives you may submit a REQUEST FOR DELETION (RFD) to our employee who will forward it to our Company Headquarters. Your RFD, if properly completed in full, will be presented to a committee, and a decision will be made as to whether to expunge said image(s) or to flag said images as noteworthy (e.g. by submitting an RFD, you should be aware that it may in fact cause your likeness to be flagged as suspicious or of special interest to the permanent archives). Part I: Declaration of reason for RFD (please circle only one): A National security: You must be a government establishment or have government affiliation (such as government funding) to select this option. B Company confidential: B1: A trade secret has been inadvertently documented by our employee. B2: Strategic marketing plans have been inadvertently documented by our employee. B3: Other company confidential ____________________________________ (please describe, use additional page if necessary) C other _______________ (please describe, use additional page if necessary) Part II: Declaration of abstinence from willful destruction of evidence of a criminal act. In recognition of the fact that measurement (photometric, radar, or otherwise) data captured by our employee may comprise evidence, in the context of a possible future criminal investigation against me or my establishment, I, the undersigned, declare that my REQUEST FOR DELETION is not for purposes of concealing criminal activity of myself or of others in my establishment. I assert that my RFD is not intended to hide criminal activity of any kind occurring within my establishment, including, but not limited to fire exits chained or otherwise fastened shut illegally, or criminal activity of myself. I further assert that my RFD is not for purposes of concealing or destroying evidence of harassment of a representative of Personal Safety Devices (PSD), or to conceal discrimination against a PSD employee. Name: ______________________________ Social Security Number: _____________________________ Signature: ___________________________ Right Thumb: +---------------+ | | | | | | | | | | | | | | | | | | | | | | +---------------+ (PSD employee to assist in centering thumb print in box) A NOTE ON PUBLIC SAFETY: You should understand that public safety (including that of our employees) is for YOUR benefit. For example, by eliminating credit card fraud, the credit card companies are able to continue to charge lower profit margins, which increases your store profits. As you are well aware, your use of surveillance cameras has reduced costs and benefits the customer (e.g. you often use the words "for YOUR protection you are being videotaped"). We appreciate your concern for your customers (us), and wish to return the gift of public safety to your establishment, in a manner in which we can all benefit, through the creation of a utopian world order of zero crime. -----------------------------for PSD use only--------------------------- Image index and type (e.g. v000100.jpg to v000199.jpg, or v123.pic), to be completed by PSD employee prior to submission to Company Headquarters __________.jpg to __________.jpg ______.pic ______.mpg ______.dat __________.jpg to __________.jpg ______.pic ______.mpg ______.dat __________.jpg to __________.jpg ______.pic ______.mpg ______.dat (use additional page if necessary)