Data Subject Access Request Form

First Name *

Last Name *

What email address do you use with us? *

You are submitting this request as *

The person, or the parent / guardian of the person, whose name appears above

An agent authorized by the consumer to make this request on their behalf.

Under the rights of which law are you making this request? *

GDPR
CCPA
CPA
CTDPA
UCPA
VCDPA
OTHER
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I am submitting a request to *

Know what information is being collected from me

Have my information deleted

Opt out of having my data sold to third parties

Opt in to the sale of my personal data

Access my personal information

Fix inaccurate information

Receive a copy of my personal information

Opt out of having my data shared for cross-context behavioral advertising

Limit the use and disclosure of my sensitive personal information

Other (please specify in the comment box below)

Please leave details regarding your action request or question.

I confirm that *

Under penalty of perjury, I declare all the above information to be true and accurate.

I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with emaxdmv.com & emaxdmv.info

I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.

By submitting, you authorize Ensurance Max Agency to send text messages with offers and other information. Reply "STOP" to opt out. Message/data rates apply. Consent is not a condition of purchase. Please refer to our privacy and policy terms https://emaxdmv.info/policy-and-privacy-terms

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