PERSONAL DATA REQUEST FORM

Please fill out this form if you wish to exercise your right to access, rectify, delete or object to further processing of the Personal Data we may have about you.

Please be advised that this online form is not designed for the submission of claims of any kind.

First Name *

Last Name *

Email *

Country of Residence *

Address of Residence *

Please provide identification that clearly shows the name, date of birth, and current address of the person the request is about. An acceptable form of identification includes: (i) a photocopy or scanned image of your passport or (ii) photo identification such as a driver’s license, national identification number card or similar, plus evidence of address such as a utility bill dated within the last three (3) months, if your photo identification does not include address information. If you have changed your name, please provide the relevant documents evidencing the change. Please note we will be unable to act on any request until we are able to properly identify you. *

Request Type *

Data Access Request (portability, access)

Data Rectification (modify or correct)

Data Erasure Request

Other

Please describe your request: *

Please specify the information and the processing activity to which your request relate. The more details you provide, the better we will be able to answer your request.

About Your Personal Information

The information you provide here will be processed solely for the purpose of verifying your identity and residency, identifying the information you're requesting, and answering your request. Your personal information will be accessed by our Privacy and Compliance teams only. Your proof of ID and residency will be deleted once your request has been answered.

How We Will Process Your Request

We will answer your request or request additional information from you within 30 days (if you are EU resident) or 45 days (if you are California, Virginia, Colorado, Utah, Connecticut, Nevada, Oregon, and Montana resident). We may extend this process for up to two months for processing, in which case we will notify you of the extension within a month.

Fees for Processing Requests

The processing of this request is free of charge, but we reserve the right, as allowed under GDPR and the applicable state privacy laws, to charge an administrative or reasonable fee under certain circumstances.

Right to Deny Personal Data Request

Please note that we may refuse to act, as allowed under GDPR Article 12 (2) and 12 (5), on requests that are insufficiently substantiated, unfounded or excessive. In addition, and under some state privacy laws, such as CCPA, a business shall deny a request to know specific pieces of personal information if it cannot verify the identity of the requestor pursuant to these regulations (§ 999.325. Verification for Non-Accountholders).

Verification and Signature

I confirm that I have read and understood the terms of this Personal Data Request Form and certify that the information given in this application to Company is true. I understand that it is necessary for Company to confirm my / the data subject’s identity and it may be necessary to obtain more detailed information in order to locate the correct personal data.

Signature *

Print Name *

Date of Signing *