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Data Access request Form
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
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.
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Under the rights of which law are you making this request?
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GDPR
CCPA
CPA
CTDPA
UCPA
VCDPA
Others
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I am submitting a request to ________
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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
Access my personal information
Fix inaccurate information
Receive a copy of my personal information
Opt out of having my data shared for cross-context behavioral advertising
Limit the use and disclosure of my sensitive personal information
Other (please specify in the comment box below)
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Please leave details regarding your action request or question.
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I confirm that
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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.
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