Free Privacy Request Form generator

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Your Privacy Request Form

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Privacy request form ([Site name])
[Site name] ([https://example.com]) · Submit by: the online form at [your request page URL], email [contact email], or toll-free [toll-free number, if you offer one]

Request type (tick all that apply):
[ ] Access: tell me what personal information you hold about me and how it is used
[ ] Delete my personal information
[ ] Correct inaccurate personal information
[ ] Opt out of the sale or sharing of my personal information
[ ] Limit the use of my sensitive personal information
[ ] Other right under the law of my state or country: ______________________

1. Full name: ______________________
2. Email address associated with your account or data: ______________________
3. Which of our products, accounts or orders this concerns: ______________________
4. Anything that helps us find your data or verify your identity (never send a password): ______________________
5. Are you submitting this as an authorized agent for someone else?   [ ] no   [ ] yes (attach proof of authority)
6. Your state or country of residence: ______________________
7. I confirm that I am the person whose data this request concerns, or their authorized agent, and that the information provided is accurate.   [ ] I agree
8. Signature (typed): ______________________   Date: ______________

What happens next: we confirm receipt within 10 business days, verify your identity using information we already hold, and respond within 45 days (one month under the GDPR); we may extend once where the law allows and will tell you why. Opt-out requests are honored within 15 business days. You will not be discriminated against for exercising your rights. We keep a record of this request for 24 months.