Consumer Request Form Δ I am submitting the following request on behalf of:* Myself On Behalf of an Individual as an Authorized Agent Please Select the Type of Request* Right to Know / Access Request Deletion of My Personal Information Correction of Personal Information in Our Possession Opt-Out of Sale or Sharing of Personal Information Limit the Use or Disclosure of My Sensitive Personal Information Access a List of Third Parties to Which My Personal Information Was Disclosed File an Appeal Opt out of ADMT Request access to ADMT information Please state the personal information you would like corrected*Name* First Last Email* Please Indicate Your Preferred Method of Communication* Email Phone / Text Mail Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code I am submitting this request as a:* Consumer Job Applicant Employee/Independent Contractor Please provide information that may be helpful in processing your request:Information on Requestor if Different Than the Consumer (Authorized Agent)*Full NameOrganization Name (If Applicable)Relationship to Consumer Subject (Continued) Information on Requestor if Different Than the Consumer (Authorized Agent)*Phone NumberEmail If you are submitting this form as part of a request that requires verification, you declare under penalty of perjury, that all the information provided here is true and correct and that you are authorized under law to make this request.
