GDPR - Right to erase request

Requester Information

Your Information

First Name *

Last Name *

Address *

Address Line 1*

Address Line 2

City*

State / Province / Region*

Postal Code*

Country*

Phone Number

Email *

Requester Verification

We require proof of your identity and address.

Proof of Identity *

Accepted Documents: Driver License, Passport, Other Government Issued Photo ID. Clearly showing name and photo.

Proof of Address *

Accepted Documents: Utility Bill, Financial Statement. Must be recent. Clearly showing name and address.

If we are unable to confirm your identity and address, we reserve the right to refuse to grant your request.

Data Subject

Person from whom information was collected.

Are you the data subject? *

Yes - I am the data subject.

No - I am acting on behalf of the data subject.

Data Subject Information

First Name*

Last Name*

Address

Address Line 1*

Address Line 2

City*

State / Province / Region*

Postal Code*

Country*

Phone Number

Email*

Data Subject Verification

Proof of Identity*

Accepted Documents: Driver License, Passport, Other Government Issued Photo ID. Clearly showing name and photo.

Proof of Address*

Accepted Documents: Utility Bill, Financial Statement. Must be recent. Clearly showing name and address.

Data Subject Written Authorization*

Signed document from data subject authorizing requester to request erasure.

Accepted Documents: Written or typed authorization letter. Hand signed. Clearly showing name and signature.

If we are unable to confirm the data subject's identity, address and written authorization, we reserve the right to refuse to grant your request.

Data

Erasure Request Reason *

Consent was originally granted but has now been removed

I/ the data subject object to the processing of personal data

Data may have been used unlawfully

Data subject is a child

Data to Remove

Is this information visible on a web page?

Yes

URL(s)

One per line

Declaration

Please note that. In certain circumstances, where erasure would adversely affect the freedom of expression, contradict a legal obligation, act against the public interest in the area of public health, act against the public interest in the area of scientific or historical research, or prohibit the establishment of a legal defense or exercise of other legal claims, we may not be able to erase the information you requested in accordance with article 17(3) of the GDPR. In such cases you will be informed promptly and given full reasons for that decision.

While in most cases we will be happy to erase the personal data you request, we nevertheless reserve the right, in accordance with Article 12(5) of the GDPR, to charge a fee or refuse the request if it is considered to be “manifestly unfounded or excessive.” However we will make every effort to provide you with the erasure of your personal data if suitable.

Please note that any attempt to mislead may result in prosecution.

I understand that it is necessary to confirm my/the data subject’s identity and address.

I understand that it may be necessary to obtain more detailed information in order to locate the correct personal data.

Signature

I consent to having my submitted information stored, as to allow the processing of my inquiry.

I confirm that I have read and understand the terms of this subject access form and certify that the information provided is true and accurate.

GDPR – Right to erase request

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