VOICE OF SPECIALLY ABLED PEOPLE
(VOSAP)
Subsidy Program – India
Beneficiary Consent and Self-Declaration Form
About Voice of Specially Abled People:
Voice of Specially Abled People Inc. (VOSAP or Voice of SAP)
is a California-based 501(c)(3) nonprofit organisation with United Nations
ECOSOC consultative status. Its mission is to empower persons with disabilities (PwD)
through access to assistive technology, scholarships, livelihood support, and advocacy programs.
In India, VOSAP operates in partnership with field partner organisations, including
the Blind People's Association (BPA) , Ahmedabad, which coordinates beneficiary outreach,
verification, and device distribution on VOSAP's behalf.
About This Form:
This form collects your personal information so VOSAP and its authorised
field partners can verify your eligibility, process your application,
and, if approved, facilitate the provision of an assistive device,
self-employment kit, or prosthetic at a subsidised rate or free of charge.
Please read every section carefully before agreeing. Please read each section carefully.
Your agreement by accepting this electronically by clicking the “I Agree” button
constitutes a binding consent and a valid contract under the Information
Technology Act, 2000, the Digital Personal Data Protection Act, 2023 ("DPDP Act"),
the Rights of Persons with Disabilities Act, 2016 ("RPWD Act"), and the Indian Contract Act, 1872.
Questions? Contact us: privacy@voiceofsap.org
| Voice of Specially Abled People Inc., 22734 Stagg St, West Hills,
CA 91304
1. PROGRAM STRUCTURE AND ROLE OF VOSAP
1.1. You are applying to the VOSAP Assistive Technology Subsidy
Program. Submission of this application is solely for the purpose of
determining eligibility for subsidy assistance and does not
constitute a purchase agreement, product order, or device delivery
commitment by VOSAP.
1.2. If your application is approved, VOSAP will notify you and the
relevant Assistive Technology Partner (“AT
Partner” ), who will supply the assistive device
directly to you.
1.3. All responsibilities relating to product quality, functionality,
defects, installation, training, support services, warranties, and
after-sales service rest solely with the AT Partner supplying the
device.
1.4. Any financial contribution required from the beneficiary or
funding partner is paid directly to the AT Partner. VOSAP does not
collect, hold, process, or retain beneficiary payments and does not
act as a seller, distributor, reseller, or financial intermediary.
1.5. VOSAP’s role is limited to eligibility verification, program
coordination, and facilitation of access to assistive technology
solutions.
1.6. VOSAP does not act as a payment processor, escrow agent,
marketplace, reseller, or financial intermediary for assistive
devices.
1.7. Assistive devices are supplied by independent third-party AT
Partners of VOSAP. VOSAP does not manufacture, design, distribute,
or control such devices and makes no representations regarding
device safety, fitness for purpose, or regulatory approvals.
Beneficiaries should consult the AT Partner for product
specifications, safety instructions, and warranty terms.
1.8. Any purchase, warranty, service, or support agreement relating
to the assistive device shall be governed by the terms and
conditions provided by the respective AT Partner.
2. WHO CAN APPLY
2.1.
To apply for VOSAP's Assistive Technology Program, you must satisfy
one of the following eligibility criteria:
2.1.1
Option A - Adult Applicant - I am 18 years of age
or older, of sound mind, and entering into this agreement on my own
behalf.
2.1.2
Option B - Parent or Legal Guardian - I am the
lawful parent or legal guardian of a person with a disability who
requires a guardian. I am acting with full legal authority on their
behalf.
I confirm that:
I am 18 years of age or older and entering this agreement on
my own behalf.
OR
I am the lawful parent or legal guardian of the applicant and
have legal authority to act on their behalf.
3. YOUR APPLICATION INFORMATION
3.1.
Please ensure the following information in your application is
accurate and complete. You will have confirmed these details during
the online application process. Details such as: Full Legal Name;
Email Address; Phone Number; State of Residence; Proof of Disability
Provided; Photograph Provided (if applicable);
3.2.
Why we ask: Each piece of information has a
specific legal purpose. Your name, email, and phone are needed to
contact you and verify your identity. Your proof of disability is
required to confirm eligibility. Your photograph, if provided, may
be used for identity verification and, with your separate consent in
Section 4, for VOSAP communications. Full details are in Section 3.
3.3.
Data Minimization Commitment: VOSAP collects only
the minimum personal information necessary to verify your
eligibility, process your application, and deliver assistive
technology. Each category of information is used solely for the
specific purposes described above and will not be used for any
incompatible secondary purposes without your additional consent.
3.4.
For more detailed information about how VOSAP collects, uses,
stores, and protects your personal information, please review our
full Privacy Policy
available at our website. By submitting this application, you
acknowledge that you have had the opportunity to review our Privacy
Policy.
4. HOW WE USE YOUR INFORMATION (DATA PRIVACY
CONSENT)
4.1.
The following explains exactly what information we collect, why,
and your rights under the DPDP Act, 2023 and applicable Indian law.
4.2.
Information We Collect and Why - The following
categories of personal information are collected, together with the
purpose of collection and the legal basis:
4.2.1.
Full Name - To identify the applicant; address and
ship the device; maintain program records.
Legal basis: Contractual necessity; as per Section 6 of DPD Act.
4.2.2.
Email Address - To send application status updates,
program notifications, and required legal notices.
4.2.3.
Phone Number - To send application updates via SMS or Call.
You expressly consent to automated SMS per Section 4.3. below.
4.2.4.
Proof of Disability - To verify eligibility under the RPWD Act, 2016.
Classified as sensitive personal data. Accessed only by authorised VOSAP
staff and the AT Partner strictly on a need-to-know basis.
4.2.5.
Financial / Socio-Economic Data - Household income details for subsidy eligibility assessment.
4.2.6.
Communication Records - Records of calls, WhatsApp messages,
and other interactions in connection with this application,
including call and verification records retained for audit purposes.
4.3.
Your Phone Number, SMS and OTP Communications -
By providing your mobile phone number in this application,
you expressly consent to receive automated SMS text messages
from Voice of Specially Abled People (VOSAP) at the number you provide.
4.3.1. Types of Messages You Will Receive:
4.3.1.1.
Messages (Required for Application Processing):
Application status updates (approval, denial, processing status),
Device delivery and tracking notifications
4.3.1.2.
Program Communications : Follow-up communications
regarding your assistive device, Program satisfaction surveys,
Impact assessment requests
4.3.2. How to Opt Out:
4.3.2.1.
You may opt out of Program Communications at any time by: Replying
STOP, Emailing privacy@voiceofsap.org
, Any other reasonable method of communication.
4.3.2.2.
We will process your opt-out request within ten (10) business days
and send you a confirmation message.
4.3.2.3.
VOSAP will not use your phone number for commercial marketing or any purpose
unrelated to your assistive technology application without your separate consent.
You acknowledge that communications for audit and verification purposes will continue
regardless of opt-out.
I have read and agreed to the communications consent above.
4.4. Sensitive Information - Your Proof of
Disability
4.4.1.
Your UDID card details and disability certificate are classified as
sensitive personal data under the DPDP Act, 2023. VOSAP treats this
information with heightened protections:
4.4.1.1. It will be used only to verify your eligibility for the
Assistive Technology Program.
4.4.1.2. It will not be sold, shared for advertising, or disclosed to
any third party except as strictly required to deliver your device
or as required by law.
4.4.1.3. It will be accessible only to authorized VOSAP staff on a
need-to-know basis.
4.4.1.4. It will be retained for 6 Months after your application is
processed, then securely Handled by VOSAP Partner - BPA,
unless a longer period is required by law.
4.4.1.5. You have the right to request deletion of this information
subject to applicable legal retention obligations.
4.4.2. Acceptable Proof of Disability: VOSAP accepts
the following documentation:
4.4.2.1. a valid Unique Disability ID (UDID) card issued by the Government of India; or
4.4.2.2. a valid disability certificate issued by a competent authority under the RPWD Act, 2016.
4.4.3. Data Security: All disability documentation
is stored in encrypted format on secure servers with role-based
access controls. Only authorized VOSAP staff with a legitimate
need-to-know may access this information.
I explicitly consent to VOSAP collecting and processing my proof of disability solely for eligibility verification and program delivery purposes.
4.5. Data Access and Retention by AT Partner
4.5.1 I acknowledge and understand that:
4.5.1.1. VOSAP collects and processes my personal data on
its technology platform for program coordination
and eligibility verification purposes.
4.5.1.2. Upon approval of my application, the relevant
AT Partner assigned to fulfil my device request will
be granted access to my personal data held on VOSAP's platform,
strictly to the extent necessary for device customisation,
procurement, and delivery.
4.5.1.3. The AT Partner may download and retain a copy of my
personal data independently for the purposes of order fulfilment,
warranty management, after-sales service, and compliance
with applicable law.
4.5.1.4. The AT Partner is bound by data protection obligations and
is permitted to use my personal data only for the purposes described
in this form. The AT Partner may not use my personal data for any
commercial, marketing, or unrelated purpose.
4.5.1.5. I understand that once data has been downloaded
and retained by the AT Partner, VOSAP's ability to compel
deletion of that copy is subject to the AT Partner's own legal
obligations and the terms of the agreement between VOSAP and the AT Partner.
5. PHOTOGRAPH AND MEDIA USE CONSENT
5.1.
This section is separate from Section 4. It governs whether
VOSAP may use your photograph or likeness for communications
and impact reporting. This consent is entirely optional and
will not affect your eligibility for the Assistive Technology
Program if you decline.
5.2. If I provide a photograph, I understand it may be used
for:
5.2.1. Identity verification during the application review process.
5.2.2. VOSAP's website, social media, donor presentations, and press
materials to highlight the impact of the program on people with
disabilities.
5.2.3. Annual reports and grant applications to support VOSAP's
mission.
5.3. I further understand that:
5.3.1. I waive any right to royalties or financial compensation for
the use of my photograph or likeness by VOSAP.
5.3.2. VOSAP will not use my photograph for advertising products or
services unrelated to its nonprofit mission.
5.3.3. I may withdraw this media consent at any time by emailing privacy@voiceofsap.org .
Withdrawal does not affect prior uses and auditing as well.
5.4. Biometric & Photograph Notice
5.4.1.
VOSAP does not use facial recognition technology, biometric
scanning, or automated facial geometry analysis. If you submit a
photograph, it will be reviewed manually for identity verification,
auditing and marketing purposes only and will not be converted into
biometric identifiers or biometric information. If applicable state
law requires additional disclosures or written consent regarding
biometric data, VOSAP will provide such disclosures and obtain
required consent before collecting or processing biometric
identifiers.
YES - I consent to VOSAP using my photograph for program documentation and public communications as described above.
6. YOUR PRIVACY RIGHTS UNDER U.S. LAW
6.1.
As a beneficiary of VOSAP's India Program, you have the following rights under the DPDP Act, 2023:
6.1.1. Right to Access [Section 11(1)]: Request a summary of personal data being processed
about you and the processing activities.
6.1.2. Right to Correction and Erasure [Section 11(2)–(3)]: Request correction of inaccurate or incomplete data,
and erasure of data no longer necessary for the purpose for which it was collected.
6.1.3. Right to Grievance Redressal [Section 11(4)]: Have grievances relating to data processing addressed by VOSAP's Grievance Officer.
If unresolved, you may escalate to the Data Protection Board of India.
6.1.4. Right to Nominate [Section 11(5)]: Nominate an individual to exercise your rights in the event of your death or incapacity.
6.1.5. Right to Withdraw Consent [Section 6(6)]: Withdraw your consent at any time.
Withdrawal applies to optional processing only and does not require
VOSAP to delete records needed for legal compliance, audit, or warranty obligations.
Withdrawal of consent to essential processing may result in discontinuation of
your application or service, and VOSAP will notify you of such consequence before acting on the withdrawal.
6.1.6. Right Against Automated Decision-Making: All decisions regarding your assistive
device eligibility involve meaningful human review.
VOSAP does not engage in solely automated decision-making that
produces legal or similarly significant effects on you.
6.2.
To exercise any of these rights, contact: privacy@voiceofsap.org .
We will respond within forty - five (45) days. VOSAP may extend this
period by an additional forty - five (45) days when reasonably
necessary, and will notify you of any extension and the reason for
the delay. Responses are provided free of charge.
7. ASSISTIVE DEVICE OBLIGATIONS
7.1.
By accepting an assistive device provided through the VOSAP
Assistive Technology Program by an authorized Assistive Technology
Partner (“AT Partner”), you agree to the following:
7.1.1. Use of the Device
7.1.1.1.
The device is provided exclusively for your personal use (or the use
of the minor/ward on whose behalf you are applying) to support
mobility, education, livelihood, or general daily activities.
7.1.1.2.
You may not sell, rent, mortgage, pledge, transfer, or give away the
device to any other person or entity.
7.1.1.3.
If the device is not used within three (3) months of delivery, VOSAP
may issue a formal notice. If unused for an additional month after
that notice, VOSAP reserves the right to reclaim the device.
7.1.2. Software and Digital Accounts (If Applicable) -
If your assistive technology includes software licenses,
digital subscriptions, or user accounts:
7.1.2.1. You are responsible for maintaining the confidentiality of
any login credentials provided.
7.1.2.2. You may not share, transfer, or sublicense any software or
digital accounts to others.
7.1.2.3. Software licenses remain the property of the respective
licensors; VOSAP grants you only a limited right to use such
software for personal assistive purposes.
7.1.2.4. Upon termination of your participation in the program or at
VOSAP's request, you agree to cease using and, if technically
feasible, return or delete any software or digital accounts
provided.
7.1.2.5. VOSAP is not responsible for third-party software
functionality, updates, or discontinuation.
7.1.3. Cooperation and Follow-Up
7.1.3.1.
You agree to cooperate with VOSAP's impact assessment team and share
progress updates, photographs, and feedback as reasonably requested
via email, phone, or messaging apps.
7.1.3.2.
You agree to allow VOSAP representatives to follow up to confirm the
device is functioning as intended.
7.1.4. Release and Limitation of Liability
7.1.4.1.
The assistive device is provided on an as-is basis. To the extent permitted
under Section 124 of the Indian Contract Act, 1872, you agree to indemnify
and hold harmless Voice of Specially Abled People Inc., its donors, volunteers,
officers, directors, and the AT Partner from and against claims arising directly
out of your misuse of the assistive device. This indemnity does not extend to claims
arising from VOSAP's gross negligence, wilful misconduct, or fraud. VOSAP's total
liability, if any, shall not exceed the fair market value of the device. Any claims
relating to product defects, malfunction, safety issues, warranty, or device
performance must be directed solely to the AT Partner supplying the device.
8. ELECTRONIC SIGNATURE, GOVERNING LAW, AND FINAL
AGREEMENT
8.1. Electronic Signature (E-SIGN Act Disclosure) -
By clicking "I AGREE" below, you agree to sign this form electronically.
Your electronic signature has the same legal effect as a handwritten signature
under the Information Technology Act, 2000 and the Indian Contract Act, 1872.
You confirm that you: (a) have the ability to access and retain electronic records;
(b) consent to conduct this transaction electronically; and (c) have had the opportunity
to save or print a copy of this form before agreeing. To withdraw your consent to
electronic transactions, contact privacy@voiceofsap.org .
8.2. Governing Law and Dispute Resolution - This form and any dispute
arising from it shall be governed by the laws of India. Any dispute shall first be
attempted to be resolved informally by contacting privacy@voiceofsap.org .
If unresolved within thirty (30) days, disputes shall be submitted to arbitration
under the Arbitration and Conciliation Act, 1996. Nothing in this form prevents you
from exercising any mandatory statutory rights available under Indian law.
8.3. Accuracy of Information - By agreeing to this form, you represent
and warrant that all information provided is true, complete, and accurate to the best
of your knowledge. Providing false or misleading information may result in disqualification
from the Program, reclamation of any device provided, and may constitute an offence
under the Bharatiya Nyaya Sanhita, 2023 and the RPWD Act, 2016
8.4. Grievance Contact - VOSAP Grievance (For India Operations):
8.4.1. Name : Mohd Faiz
8.4.2. Email: Faiz@voiceofsap.org
8.4.3. Grievances will be acknowledged within forty-eight (48) hours
and resolved within thirty (30) days.
8.5. Accessibility Accommodations - This form is available in alternative
accessible formats, including regional Indian languages, large print, and screen-reader
compatible versions. If you require accommodations to complete this application due to
your disability, please contact privacy@voiceofsap.org .
VOSAP is committed to ensuring equal access to its programs for all persons with
disabilities in accordance with the RPWD Act, 2016.
8.6. Final Declaration - By clicking "I
AGREE" , I solemnly declare and confirm that:
8.6.1. I have read (or had read to me in a language I understand) and
fully understand every section of this form.
8.6.2. All information I have provided in my application is true,
accurate, and complete.
8.6.3. I meet the eligibility requirements stated in Section 2.
8.6.4. I declare that my total household income from all sources is below
the mentioned threshold per year for the device i am applying for. I understand
that VOSAP reserves the right to request documentation of income eligibility.
8.6.5. I voluntarily, freely, and without coercion give my informed,
specific, and unambiguous consent to all items I have checked above.
8.6.6. I understand this is a legally binding agreement under the Information Technology
Act, 2000, the DPDP Act, 2023, and the Indian Contract Act, 1872.
8.6.7. I understand that VOSAP is purely a subsidy facilitation
mechanism, and that all product and service responsibilities lie
with VOSAP's AT partner and myself.