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Consumer Privacy Rights Request Form

If you are a resident of California, Colorado, Connecticut, Delaware, Iowa, Montana, Nebraska, Nevada, New Hampshire, New Jersey, Oregon, Tennessee, Texas, Utah or Virginia, you may be able to make a data deletion request, data portability request, correction request and/or information disclosure request by indicating below, and providing the requisite information. For additional discussion of your privacy rights, please visit our Privacy Policy by Clicking Here.

First Name

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Last Name

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Email Address

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Phone Number

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Address

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Address 2

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City

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State

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Zip Code

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Select one option:

Select one option.

Data Deletion Request

Data Portability Request (the specific information that we have collected about you)

Information Disclosure Request (where we collected your information from, to which categories parties we shared it with, the associated business purposes for each and additional required disclosures)

Information Correction Request (you can request that we correct the personal information that we have on file for you)

Describe your request with sufficient detail that allows us to properly understand, evaluate and respond to it:

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Users with disabilities (and any other users) who wish to make a data deletion request, data portability request, correction request and/or information disclosure request can also contact us by emailing us at: support@mysurveyslist.com; calling us at: 1-844-686-0160; or sending us U.S. mail to: .

Where you make a data deletion request, data portability request, correction request and/or information disclosure request through an authorized agent, we will require that you or the authorized agent provide us with a valid written authorization executed by both parties, with the validity of such document determined by us in our reasonable, good faith discretion. Please submit such documentation to us at: support@mysurveyslist.com, or .

Making a verifiable consumer request does not require you to create an account with us. However, we do consider requests made through your password protected account sufficiently verified when the request relates to personal information associated with that account.

We will only use personal information in a verifiable consumer request to verify the requestor's identity or authority to make the request.

You may only make a verifiable consumer request for access or data portability twice within a twelve (12)-month period.