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Data Subject Access Request Form
Please fill in the information below. The website administrator or data protection officer will be notified of your request within 24 hours, and will need an appropriate amount of time to respond.
Website
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Your Name
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What email address do you use to access the above website / app ?
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You are submitting this request as
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You are submitting this request as
The person, or the parent / guardian of the person, whose name appears above.
An agent authorized by the consumer to make this request on their behalf.
Under the rights of which law are you making this request ?
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I am submitting a request to ___________
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I am submitting a request to ___________
Know what information is being collected from me
Have my information deleted
Opt out of having my data sold to third parties
Opt in to the sale of my personal data
Other (please specify in the comment box below)
Please leave details regarding your action request or question.
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I confirm that
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I confirm that
Under penalty of perjury, I declare all the above information to be true and accurate.
I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with My Great New Website / App.
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