Request to Withdraw from ADISA Certification Scheme

This form should only be used by an ITAD who wishes to withdraw from the scheme

If you have navigated to this URL and want more information about ADISA, please email info@adisa.global

  • SECTION 1: CERTIFIED COMPANY INFORMATION

  • Please list the address of the facility to be withdrawn. Where multiple sites are to be withdrawn please use a separate form as each site has its own approval number
  • SECTION 2: CONTACT INFORMATION

  • NameJob TitlePhonee-mail 
  • SECTION 3: WITHDRAWAL REASONS

  • * I must cease the use of the certification mark.
  • * I must make no further reference to certification.
  • * I must inform data controller or data processors of the withdrawal in all instances where certification was stated during the engagement process.
  • * Please note that ADISA will notify the ICO about the withdrawal.
  • The membership fee will become due to join the onboarding program but your membership renewal fees will be due annually on the date of your final audit.
  • Please print your name as a signature to confirm your request.