CCPA REQUEST FORM

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CCPA REQUEST FORM - Afilias

In order to process your request, we need some basic information from you. The information requested in this form is important to Afilias' efforts to fully process your request.

Please note: If you choose not to provide the information requested in this form, we will be unable to process your request and will take no further action.

Email *

First Name *

Last Name *

Account Name / Username / Domain (where applicable)

What type of request are you making? *

At Afilias, we take your right to privacy seriously. We strive to protect the rights, freedoms and dignity of all those who entrust us with their personal information, including learners, customers, and employees. We recognize our responsibility to keep your personal information safe and secure, and we have systems, processes, and expert staff devoted to implementing such security controls, and safeguarding data protection, across our business. In order to fulfill this request, Afilias will need to reasonably validate that you are the owner of the account for which this request is being submitted. This may require additional follow-up to ensure confidence that this request can be fulfilled. We will work to fulfill this request in a timely manner that complies with the legal requirements in your jurisdiction. *

I DECLARE UNDER PENALTY OF PERJURY THAT I AM A RESIDENT OF CALIFORNIA AND I AM THE INDIVIDUAL CONSUMER WHOSE PERSONAL INFORMATION IS THE SUBJECT OF THE REQUEST

I DECLARE UNDER PENALTY OF PERJURY THAT I AM THE AUTHORIZED AGENT OF THE INDIVIDUAL WHOSE PERSONAL INFORMATION IS THE SUBJECT OF THE REQUEST. I UNDERSTAND I WILL BE REQUIRED TO PROVIDE WRITTEN PROOF OF MY STATUS AS THE INDIVIDUAL'S AUTHORIZED AGENT AND ADDITIONAL INFORMATION TO CONFIRM MY IDENTITY.

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