Authorized Agent Privacy Rights Request Under certain laws, consumers may delegate the authority to exercise their privacy rights (including the right to access, the right to opt out of sale or sharing, the right to correct inaccuracies, the right to limit use or disclosure of sensitive personal information, and the right to delete) to an authorized agent. This form is provided for authorized agents to submit privacy requests on behalf of consumers. If you are a consumer seeking to exercise your rights, please visit our Consumer Privacy Request Form. Please review our Privacy Policy for additional details. First Name(Required)Last Name(Required)Address(Required) Street Address Address Line 2 City Consumer State *AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Consumer Email(Required) Phone(Required)Authorized Agent Email(Required) Privacy Choice(Required)Privacy Choice *Request to opt out of sale/sharingRequest to correct inaccuraciesRequest to deleteRequest to accessRequest to limit use/disclosure of sensitive personal informationHelp text: Please describe the information that you would like to be corrected here.Permission to authorize(Required) By submitting, I understand that I may be required to verify my authority to make this request, and I authorize Data Axle to contact me for purposes of honoring this request. I attest that the information provided in this request is true, accurate, and complete to the best of my knowledge. I also attest that I am authorized by the consumer to submit this request on their behalf. Upload Authorized Agent Form *(Required)Accepted file types: pdf, doc, jpg, png, Max. file size: 5 MB.