California Privacy Rights Request

California Privacy Rights Request

This form is to be used if you are a California resident exercising your rights under the California Privacy Rights Act.

Select your relationship with Verizon.*

For Authorized Agents, please provide the details of the individual you are submitting the request on behalf of.

Applicant Only

Statement of Work (SOW) Worker

Time & Material (T&M) Worker

1099 Worker

Authorized Agent

First Name*

Last Name*

Does/did the individual have a Verizon email?*

Select

Individual's Verizon Email Address

Current or prior email address

Did the individual have an Enterprise ID (EID)?*

Select or enter value

Individual's Enterprise ID (EID)

Individual's Date of Birth*

Please use format MM-DD, omit the year

Individual's Start Date with Verizon*

Individual's End Date with Verizon

If actively working with Verizon, leave blank

Supplier's Name*

Current employer (or former employer) of the individual

Current Email Address*

This email will be used as a mode of contact about this request

Current Phone Number*

This phone number will be used as a mode of contact about this request

State of Residence*

At time of employment

Select

Purpose of Contact*

I would like to know what personal information Verizon collects about me. [Right of Access]

I would like to know how Verizon handles personal information it collects about me. [Right to Know]

I would like to delete personal information Verizon collected from me. [Right to Delete]

Some personal information is incorrect, and I would like to get it updated. [Right to Correct]

Other

Date Range of Request*

Select

Custom Date Range Start

Custom Date Range End

Reason for Contact*

Details of the request.

Please provide any supporting documentation

Drag and drop files here or

Send me a copy of my responses