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Data Subject Access Request Form
What is your full name?
name
name
What is the email address you use to access this website?
email
email
I am submitting this information on behalf of:
Myself
Someone else
What is the reason for your request?:
Get a copy of my personal information
Edit or correct my personal information
Restrict the processing of my personal information
Delete all my personal information
I confirm the following:
Under penalty of perjury, I declare all the above information to be true and accurate.
*
I am the consumer of the above website or the agent authorized by the consumer to make this request on their behalf.
*
I understand that the deletion or restriction of my personal information is irreversible and may result in the termination of services with the above website
*
I have read and agree to the privacy policy and I understand that I will be required to validate my request by email and I may be contacted in order to complete the request
*
Submit