Acknowledgement
Option A
- The driver says
- I received and understood this notice.
- Records
- That the driver was informed.
Driver privacy · Free Word template
DSM driver-camera consent: face, audio and AI alerts
A four-page form for what only a driver-facing DSM camera adds: face and eye analysis, snapshots, audio and AI alerts. It tells the driver what is analysed, who sees it and for how long, and ends with an acknowledgement or a consent, as your legal adviser decides.
Free: enter your name and email and we send you the file. Works in Word, Google Docs and LibreOffice Writer.
- Cameras, audio and DSM detections
- Legal-review note inside
- Signature and change record
- Road-facing camera (ADAS)Fitted
- Driver-facing camera (DSM)Fitted
- Audio is not recordedTicked
- Face identification: ask legal firstCheck
- Retention periods written in
Needs legal review before use
This form can describe sensitive data, especially face data and audio. Whether you need an acknowledgement, a consent or both depends on your country and your employer, and a consent given by an employee may not be enough on its own. The form does not say that any law is met. Ask your legal adviser.
What's inside
Eleven parts, and what the main ones ask of you
You fill in all eleven parts. The table shows eight of them, and some also need a check against your device datasheet or a word from your legal adviser.
- You fill in
- Check the datasheet or ask legal
- Not needed
| Part | Fill in | Device datasheet | Legal review |
|---|---|---|---|
| Cameras and where they look | You fill in | Check | Not needed |
| Audio, yes or no | You fill in | Check | Check |
| DSM detections used | You fill in | Check | Not needed |
| Face identification | You fill in | Check | Check |
| Purposes and banned uses | You fill in | Not needed | Check |
| Who can view | You fill in | Not needed | Check |
| Retention and deletion | You fill in | Check | Check |
| Rights, questions and complaint route | You fill in | Not needed | Check |
Last page of the form
Acknowledgement or consent?
The form carries both, so your legal adviser can keep the one that fits and delete the other.
Consent
Option B
- The driver says
- I agree to the items listed.
- Records
- What the driver agreed to, and what happens if not.
We do not choose for you
Which option is valid depends on your country and your employer.
What should a driver notice tell the driver?
The driver should be able to read one page and know five things.
- Which cameras are fitted and where they look.
- Whether sound is recorded, and when video is saved.
- What the DSM camera looks for, such as drowsiness or phone use.
- Who can watch the recordings and how each view is logged.
- How long recordings are kept and who to ask.
Why do face data and audio need extra care?
A camera that only watches for signs of drowsiness is different from a system that identifies a person by face, and sound can capture other people. The form asks about both separately and lets you write down the purpose, the place and the period.
Do not assume
Tick face identification only if your device does it. Check the datasheet. If face data is stored, ask your legal adviser before you use it.
When should you give a new notice?
Give the driver a copy, in a language the driver understands, and keep the signed original. Use the change record on the last page whenever something changes, for example when audio is turned on or a new detection is added.
How do you fill it in?
- Fill in the camera table and the audio and recording mode first.
- Tick only the DSM detections your device really offers.
- Write your own retention periods, the same as in your camera policy.
- Ask your legal adviser which of A or B to keep, and what to write if the driver does not agree.
Limits of this template
A signed form does not make a recording lawful. It records that the driver was told. The basis for recording, the right to refuse and the rules on sensitive data are matters for your legal adviser.
Related Tracom solution
A DSM camera with the notice to match
Tracom M1N is an MDVR. Camera options such as DSM/ADAS are confirmed with the Tracom team. Tell us what you want the camera to flag and we will show how M1N handles it, so the notice says what the system does.
- Tracom M1N MDVR. Camera options such as DSM/ADAS are confirmed with the Tracom team.
- Voice alerts. Driver behavior monitoring with voice alerts.
- SCMS portal. Manage devices in one place.
- Ask for the datasheet. Check what your model records before you tick.
Is the driver's signature enough?
A signature shows the driver was told. Whether it also counts as consent, and whether consent is needed, depends on your country and employer. Ask your legal adviser.
Can a driver refuse?
That is a legal and employment question. The form has a line for what happens if the driver does not agree. Your legal adviser writes it.
Does the DSM camera identify the driver by face?
Do not assume it does. Check your device datasheet and your platform settings. The form asks you to state clearly whether face identification is used.
Do drivers sign again when settings change?
Give a new notice when something important changes, such as audio or a new detection. The change record on the last page tracks it.
Does it work in Google Docs?
Yes. Upload the .docx file to Google Drive and open it with Google Docs. It also works in Word and LibreOffice Writer. Check the Arabic layout after you edit it.
What is Tracom's role here?
Tracom makes the devices. The form is a neutral template. It does not replace your legal review, and it does not say that any law is met.
Next step
Tell drivers before the camera records
Bring your camera list. We will show how the M1N MDVR works and confirm camera options such as DSM/ADAS, so your notice matches the system.
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