| *First Name: |
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| *Last Name: |
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| Email Address: |
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| * State: |
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| I am |
- Customer
- Employee/Former Employee
- Job applicant
- Business Customer
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| Type of Request(s) (check all that apply) |
- Request to access information we collect about you
- Request to correct your personal information
- Request deletion of your personal information
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| Type of Requester (please select one): |
- I hereby certify under penalty of perjury that I am making this request on my own behalf.
- I am the parent/legal guardian of the minor who is the subject of this request.
- I am an authorized agent acting on behalf of the person listed above who has authorized me to make this request.
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If you are not making this request on your own behalf, please provide the following additional details:
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| *Your First Name: |
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| *Your Last Name: |
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| Email Address: |
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Additional Requirements for Authorized Agents
If you are making this request as an authorized agent, please email either (1) a written and signed authorization from the individual that is the subject of this request, indicating you have authority to submit this request, or (2) a power of attorney from the individual that is the subject of this request. Send emails to privacy@etcconnect.com.
As required by law, we will contact you to confirm your identity and may ask you to provide additional documentation. We may deny requests from agents that do not submit sufficient proof of their authority to make rights requests. Furthermore, we may require the subject of the privacy request to verify their own identities or confirm that their agents have permission to submit rights requests on their behalf. Requests may be denied if they cannot be verified or confirmed. |