Consumer Rights Request Form

Depending on where you reside, you may have certain data protection rights under local law.

To exercise these rights, please complete and submit this form. For more information regarding how we process your information, please see our Privacy Policy.

Important Note: The information provided in this form will ONLY be used for purposes of processing your consumer rights request and to communicate with you concerning your request.

To process your consumer rights request, we need to verify your identity: (*= required)

First Name

Last Name

Email Address

Phone Number

I am making this request on behalf of myself. I am not the individual listed above, but certify that I am an authorized representative making this request on behalf of the listed individual.

State of residence *

[Select state] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Check the applicable box to specify your request:

Delete my Personal Information. Show me the Personal Information you have collected about me. Provide me details of the collection, use, and disclosure of the Personal Information you have collected about me. Opt out of sharing my Personal Information for targeted advertising.

By clicking “Submit” below, I attest that I am the consumer named in this Request Form, or a person legally authorized to act on behalf of the data subject or consumer.

When you click “Submit” below, an email will be sent to the email address provided asking you to verify your identity.

 

Submit

For our Privacy Policy, go to https://www.halsbrook.com/pages/privacy-policy