Privacy Request Form

We provide consumers in certain states the right to make certain requests related to our processing of their Personal Information, including the ability to opt out of the sale and sharing of their Personal Information, as explained more fully in our Privacy Policy. Exemptions may apply. You may use this form to make your privacy rights request.

Contact Information

Full Name

Email Address

Phone Number

Zip

Address

City

State

Agent Information

Are you submitting this request as an authorized agent for the above consumer?

Agent Full Name / Business Name

Agent Email Address

Agent Phone Number

Agent Address

Please upload evidence of authorization to act on the consumer’s behalf. This evidence must be either a lawful power of attorney or written and signed permission from the consumer.

Request & Preferences

How do you prefer we contact you regarding your request (choose all that apply)?

Mail
Email
Phone

What type of request are you making?

Opt out of sale or sharing of Personal Information
Request to know the Personal Information maintained by the business
Request to delete Personal Information
Request to correct Personal Information
Appeal denial of a privacy request

Please explain the information you believe needs corrected

You may upload supporting documents here

Please explain the basis for your appeal request

You may upload supporting documents here

Privacy Request Form

Contact Information

Agent Information

Request & Preferences

Encrypting your data...

Thanks for reaching out!