Data Subject Access Request Form (DSARF)

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Name *

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Last

Email *

You are submitting this request as *

The person whose name appears above.
An agent authorized by the consumer to make this request on their behalf.
The parent / guardian of the person, whose name appears above.. Please provide your name in the comment box below

Name of parent or guardian

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Last

Under the rights of which law are you making this request? *

If selecting “Other”, please provide information in the text box below

Other law provision to which you making this request?

I am submitting a request to ___________ *

Know what information is being collected from me
Have my information deleted
Opt out of having my data sold to third parties
Opt in to the sale of my personal data
Access my personal information
Fix inaccurate information
Receive a copy of my personal information
Opt out of having my data shared for cross-context behavioral advertising
Limit the use and disclosure of my sensitive personal information
Other (please specify in the comment box below)

Please leave details regarding your action request or question.

I confirm that *

Under penalty of perjury, I declare all the above information to be true and accurate.

I confirm that (copy) *

I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with My Great New Website / App.

I confirm that (copy) *

I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

1 Peter 3:15

But in your hearts revere Christ as Lord. Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have. But do this with gentleness and respect,

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