Personal Information Rights Request Form
Jacob & Co. will be sending you an acknowledgement email. Kindly review it carefully as we may need to request more information to process your request. We need to verify your identity, as required by law, so we will need you to supply certain personal information along with your request. If you are making a request on someone else’s behalf, we may need you to provide us with evidence of your relationship to the person about whom the request relates. Please know that Jacob & Co. may not be obligated to follow through with your request or respond in the way you anticipated if you make a request to exercise a right to which you are not entitled, if your request conflicts with law, or if your request is subject to exceptions provided for in the law.
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Email *
What is the nature of your request? *
For Others (Please describe below)
Complete Name (Name of the person that is the subject of the request) *
Relationship to subject *
Email address (Email address to communicate about this request) *
Location (Applies to the subject of the request) *
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