What's interesting about this and similar forms is that there is no owner information on the form. No name of the party that is to receive this information. You fill it out and effectively give your information to any anonymous interested party. And if you indicate any reluctance to give out your information in this manner they get testy with you.
In the USA there should be a privacy statement with this form. And the originator of the form should have identified himself/herself/itself on the form.
If anyone is tempted to fill this out, demand that the requesting elder put his name and contact information on the form and tell him you must xerox it first. And demand in writing to know everyone this information will/could be given to. And tell him it is only out of legal consideration that you want this.
And then stand back and watch him walk away from you (in disgust, of course, over your "disobedient attitude").