California Consumer Request Form

Requestors Full Name (required)

Requestors Full Email (required)

STATE OF RESIDENCE
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Are you the consumer?
Yes, I am making a request related to personal information about me.No, I am acting as an authorized agent for the consumer. I have enclosed a California Authorized Agent Designation form completed and signed by the consumer.

Request for online activity information
If your request applies to online activity information that My Deme, Llc. companies may have collected through cookies or similar technologies, you must make your request from the browser or device that you have previously used to access My Deme, Llc. websites. This allows us to read any identifier that we have assigned to your browser or device.

Specify the request(s) – check all that apply
Request to know categories of personal information My Deme, Llc companies have collected, used, disclosed, and/or sold about the consumer.Request to obtain specific pieces of personal information My Deme, Llc. companies collected about the consumer.Request to delete personal information My Deme, Llc. companies have collected about the consumer.Request to opt out of the "sale" of personal information about the consumer.

Disclaimer: By submitting this form, I hereby certify that the information entered into this form is complete, accurate, and up-to-date, and that I am the consumer who is the subject of the request or have been authorized by that consumer to act on his/her behalf, as indicated above. I understand that it may be necessary for My Deme, Llc. companies to verify the identity of the consumer and/or authorized agent for this request, and additional information may be requested for this purpose.

Δ