Many U.S. State Privacy Laws provide consumers with rights regarding personal information, like the right to make Requests to Access, Correct, Opt-out of Sale, and Delete. To make a request, please fill this form out completely and Datamasters will respond as outlined in our privacy policy. We may need further verification of your identity or clarification of your request before responding. Personal information provided on this form won’t be used except to respond to your request. For details on your rights under privacy law, details of which state privacy laws apply to Datamasters, how requests work, and how we respond, please visit our privacy policy at https://www.datamasters.org/privacy-policy/

REQUESTER INFORMATION:

Name of Requester *

Email of Requester *

Mailing Address: *

City *

State *

Postal Code *

SPECIFY TYPE OF REQUEST – CHECK ALL THAT APPLY:

I would like to make the following type(s) of CCPA request(s):

Request to delete some personal information Datamasters has collected on me

Request to delete all personal information Datamasters has collected on me

Request for access to all personal information Datamasters has collected on me

Request for access to categories of personal information Datamasters has collected on me

Request to correct certain personal information Datamasters has collected on me

Opt out of the sale of personal information Datamasters has collected on me

DECLARATION: BY SIGNING BELOW, I HEREBY CERTIFY THAT THE INFORMATION ENTERED INTO THIS FORM IS COMPLETE, ACCURATE AND UP-TO-DATE, AND THAT I AM THE CONSUMER WHO IS THE SUBJECT OF THE REQUEST OR HAVE BEEN AUTHORIZED BY THAT CONSUMER TO ACT ON HIS/HER BEHALF, AS INDICATED ABOVE. I UNDERSTAND THAT IT MAY BE NECESSARY FOR DATAMASTERS TO VERIFY THE IDENTITY OF THE CONSUMER AND/OR AUTHORIZED AGENT FOR THIS REQUEST, AND ADDITIONAL INFORMATION MAY BE REQUESTED FOR THIS PURPOSE

Signature *

Clear

Printed Name *

Date *