Requests to Delete

Please identify the person filling out this form *

If you are filling this form out for yourself: please print, sign and scan the 'Individual Request Form' attachment above. If you are filling this form out for someone else as an Authorized Agent: please print, sign and scan the 'Authorized Agent Verification Form' attachment above. If you are filling this form out for your household: please print, sign and scan the 'Household Verification Form' attachment above. If you are under the age of 13, you must have a parent or guardian submit the request using the ‘Parental Request Form’ attachment above.

I am submitting this form on behalf of myself I am submitting this form on behalf of someone else, as an Authorized Agent I am submitting this request on behalf of my household I am submitting this request as a parent or guardian of a child under 13 years of age

By checking the box below, I am confirming that all of the information entered in the attached documents is true and accurate. *

YES

Please enter the first and last name associated with this request: *

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Please enter the email associated with this request: *

Please note: all future communications to process this request will be held through the email address entered here. If you require special accommodations to process this request over the phone, please denote this in the comments at the end of this form.

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Please enter the phone number with this request: *

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Please enter the address associated with this request: *

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Additional Comments:

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Please attach the form which best corresponds with your status as a requestor.

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