First Name

Last Name

Phone Number

Address

City

Postal Code

Country

How should we contact you if we have questions about your request?

Are you the person who is the subject of this request? Yes, the personal information at issue is about me (we will ask you to confirm your identity)No, I am acting on behalf of the person who is the subject of this request with their express permission, or with the appropriate legal authority (we will ask for appropriate verification)

In what capacity are you making this request?

Which right(s) would you like to exercise? Access my personal information: show me what you haveKnow categories of personal information: tell me what you haveDelete my personal information: destroy the data you haveCorrect my personal information: update the data you haveRestrict processing of my personal information: limit uses of the data you have but do not delete (must specify data to be restricted and provide a reason for the request)Download my personal information: give me the data you have in structured formatObject to processing my personal information: stop processing the data you have[For California Residents] – Limit the Use of My Sensitive Personal Data

Is there specific information your request relates to?

When/how did you provide us with this information, if relevant? (Approximate dates will help us)

If you would like to limit your request to certain dates or categories of information, please specify.

Comments

Please note, depending upon the nature of your request, we may request additional information or documentation in order to verify your identity. To streamline our efforts to authenticate your identity, we may request for you to provide us with a scanned copy of a government issued ID with the identification numbers redacted or blacked out.