Please complete this form in order to submit a data subject request pursuant to the applicable Data Protection Laws. Upon receipt of your completed request, we will process it and respond within the timelines required by the law. If additional information is necessary, we will contact you using the contact information you provided in this form.
Information provided in connection with this request will be processed only for the purpose of processing and responding to your request and will be deleted immediately thereafter.
If you have contacted us or provided us with additional information, please proceed with the form below.
Address (including ZIP): _____________________
Email Address: _____________________________
Phone Number (optional):_____________________
Please check the applicable box:
- I would like to receive information regarding why and how you are processing my information.
- I would like to receive a copy of the personal data you process with respect to me.
- I believe the personal data that you retain with respect to me is incorrect and I would like to correct it (only applicable under the GDPR).
- I would like you to delete the personal data you retain with respect to me.
- I would like you to stop processing my personal data.
- I would like you to stop sending me direct marketing.
- I would like to receive information about public and private entities with which my Personal Data was shared.
- I would like to receive a copy of my data and transfer it to a third party.
- I want to withdraw my consent for the processing of my personal data (only applicable under the GDPR).
- I would like to object to the processing of my personal data (only applicable under the GDPR). **
Substantiate the request- please provide additional information about your request:
What is your relationship with us (customer, consumer, partner, etc.):
Verification of Identity
In order to keep our customers safe we need to make sure you are indeed who you say you are, for this reason we need to verify your identity. Therefore:
Please attach a photo ID document (i.e., driver’s license, passport):
Please provide proof of address so we can confirm you are a European resident or a California resident (attach one of the following: utility bill, bank statement, driver’s license, or tax document).
Thank you for filling out the form, please email it to our data protection officer at: firstname.lastname@example.org together with the above required documentation.
We will process the request by the time specified in the Data Protection Laws, we reserve the right to extend the aforementioned period by the time specified in the Data Protection Laws if the request is complex or numerous or we require additional information. The processing of the request is free of charge, however, we may want to reserve the right to charge a reasonable fee to cover certain administrative costs (such as providing additional copies of the data) or for handling manifestly unfounded or excessive requests.
* It is important to note that under the CCPA your rights only apply to the Personal Information (as defined therein) that was collected 12 months prior to your request and you are not entitled to submit more than 2 requests within a 12 month period.
** Under the CCPA you have the right to opt out of the sale of personal information. In the event we will sell Personal Information, we will provide you with information on how to exercise your right to opt-out (by providing with applicable “DO NOT SELL MY DATA” feature.