Consumer Privacy Request Form

1. Verify Your Identity

Before we can process your request, we need to confirm who you are. Please share the details below.

First Name *

Last Name *

Email Address *

Phone Number *

2. Select Request Types

Choose every type of privacy request that applies to you.

Right to Know/Access: Request a copy of the personal information we have collected about you

Right to Delete: Request deletion of your personal information

Right to Correct: Request correction of inaccurate personal information

Right to Opt-Out: Opt out of the sale or sharing of your personal information

Data Portability: Request your data in a portable, machine-readable format

Limit Processing: Request to limit the use of your sensitive personal information

4. Account Information (Optional)

If you have done business with us in the past, the details below can help us find your records more quickly.

Account number or ID

Approximate date of last interaction

5. Authorized Agent

I am submitting this request as an authorized agent on behalf of a consumer.

Agent name

Agent email

Agent phone

Authorization documentation

Please upload a signed authorization letter, power of attorney, or other legal documentation.

What Happens Next

Response timing. We will confirm receipt of your request within 10 business days and provide a substantive response within 45 calendar days. If we need more time, we may extend that period by up to an additional 45 days (for a total of up to 90 days) as permitted by law.

Identity verification. We may need to verify your identity before acting on your request. If the information you provide is not sufficient, we may follow up to ask for additional details.

Appeals. If we deny your request, you may appeal. Our response will include instructions for doing so.

No retaliation. We will not discriminate against you for exercising any privacy right.

Questions. If you have questions about this form or your privacy rights, email us at [email protected].

Consumer Privacy Request Form

1. Verify Your Identity

2. Select Request Types

3. Your Relationship to Us

4. Account Information (Optional)

5. Authorized Agent

6. Contact Preferences

Additional Details

What Happens Next