Annual Encryption Key Access Acknowledgement Form
Purpose
This form confirms that the individual listed below understands and accepts the responsibilities associated with access to encryption keys that protect cardholder data or other sensitive information.
Employee Information
- Name: ____________________________________________
- Job Title: _________________________________________
- Department: ________________________________________
- Email: ____________________________________________
- Date: ____ / ____ / ______
Acknowledgement
I acknowledge that:
- I have been granted access to one or more encryption keys that are used to secure cardholder data or sensitive information.
- I understand that encryption keys must be protected at all times and must not be shared or exposed to unauthorized individuals.
- I have reviewed and understand the company’s Encryption Key Management Policy and agree to follow it.
- I understand that unauthorized disclosure, sharing, or mishandling of encryption keys may result in disciplinary action, including termination and possible legal consequences.
- I will immediately report any suspected loss, exposure, or misuse of encryption keys to my manager and the security team.
Signature
Employee Signature: ____________________________
Date: ____ / ____ / ______
Manager/Security Lead Name: ______________________
Signature: ____________________________
Date: ____ / ____ / ______