Home » Citizens Disability™ Privacy Policy » CTDPA Opt-Out Form

CTDPA Opt-Out Form

Please see additional notes below the form.

"*" indicates required fields

Name*

First Last

Address*

Street Address City State Zip Code

Phone*

If you choose to proceed without providing an email address, we may have difficulty processing your request and we will have to communicate with you about your request via postal mail. This may cause significant delays in processing your request.

Please Select ONE*

Delete my personal information Deletion requests only apply to information we have collected about you up until the time we process your request. We will not delete pieces of information that are needed to comply with our legal obligations, comply with record management requirements, or as otherwise permitted by law.

Correct my personal information: The right to correct data allows you to request that we amend inaccurate personal information we have collected about you.

Request My Personal Information: (where we collected your information from, to which categories parties we shared it with, the associated business purposes for each and additional required disclosures). We may send you the information we collected within the 12 months before you submitted your request, although some information may have been collected before that 12-month period.

Please Select One*

PERIOD OF DATA

Additional detail that may allows us to properly understand, evaluate and respond to your request:

CAPTCHA

Comments

This field is for validation purposes and should be left unchanged.

Users with disabilities (and any other users) who wish to make a data deletion request, data portability request and/or information disclosure request can also contact us by emailing us at: emailing us at: privacy@citizensdisability.com; calling us at: (888) 757-4011; or (781) 516-7715; or sending us mail to: Citizens Disability, 1050 Winter Street, Suite 1000, Waltham, MA 02451.

We respect the privacy of your personal information. The information you provide here will only be used to process your opt out of sale request. To assure the implementation of your request across all devices associated with your account, you should login to your account with each of your devices. If you are not logged in or do not provide accurate account details, you should complete an opt out of sale request on each browser or device that you use to access our websites and mobile services. In addition, if you are not logged into your account while making your request, and you later clear your cookies, your opt out of sale request will need to be resubmitted. Please note that your request will apply to future sales of your personal information and will not impact sales made prior to your request.

If we have a good-faith, reasonable and documented belief that a request to opt-out is fraudulent, we may deny the request.

Where you make a request to opt-out of the sale of your personal information through an authorized agent, we will require that you or the authorized agent provide us with a valid written authorization executed by both parties, with the validity of such document determined by us in our reasonable, good faith discretion. Please submit such documentation to us at: privacy@citizensdisability.com; or: Citizens Disability, 890 Winter Street, Suite 230, Waltham, MA 02451.

For additional discussion of your privacy rights, please visit our Privacy Policy.