Your Privacy Choices Privacy Request Form Catalist respects the privacy interests of individuals whose information we receive and is happy to honor privacy requests as set out in our Privacy Policy. Such requests may be made by completing this form or otherwise contacting us as described in Privacy Options. For security and safety purposes, you may need to confirm your possession of an identifier, identifying information, or to provide a piece of identification that confirms you are the person you claim to be. Please note that this Privacy Request Form is for privacy requests only. We are not able to respond to any other requests or messages submitted via this Privacy Request Form. All information submitted in this Privacy Request Form will be deleted in accordance with our privacy policy following completion of your request.In which state do you reside?(Required)-- Select --CaliforniaColoradoConnecticutAny other stateI would like to(Required)delete and opt out of the sale of my personal informationcorrect my personal informationaccess my personal informationlimit the sale of my personal informationI would like to(Required)delete and opt out of the sale of my personal informationI would like to(Required)delete and opt out of the sale of my personal informationcorrect my personal informationaccess my personal informationappeal the denial by Catalist of a prior privacy requestHiddenConsumer InformationFirst Name(Required) Middle Name Last Name(Required) Suffix AddressStreet Number(Required) Street Name(Required) Unit Number Address Line 2 State(Required)CaliforniaState(Required)ColoradoState(Required)ConnecticutState(Required)AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCity(Required) Zip Code(Required) Birthdate(Required) MM slash DD slash YYYY Email(Required) Phone(Required)Is an authorized agent making this request on your behalf?(Required) I am making this request on behalf of myself. I am an authorized agent making this request on behalf of a consumer. Please note that authorized agents will be required to provide written proof of authorization and may be required to provide additional identity verification. HiddenAgent InformationName of Authorized AgentFirst Name(Required) Middle Name Last Name(Required) Suffix Company Name(Required) Address of Authorized AgentStreet Number(Required) Street Name(Required) Unit Number Address Line 2 City(Required) State(Required) Zip(Required) Email(Required) PhoneIn addition to the other information requested in this form, Catalist requires written proof of authorization to process privacy requests made by an authorized agent on behalf of a consumer. Written proof of authorization must be emailed to [email protected] or mailed to Catalist LLC at 1310 L Street Northwest, Suite #500, Washington, DC 20005, Attn: Data Privacy. The written authorization must be signed and dated by the consumer and include the consumer’s first name, last name, email address, and telephone number, along with the business name of the authorized agent and specifying which rights the consumer has authorized the authorized agent to exercise. A valid email address for the consumer is required so that we may directly contact the consumer for identity verification purposes. Please indicate whether you will be emailing or mailing written proof of authorization.(Required)EmailMailHiddenDeclaration(Required) We are not able to respond to requests that are incomplete. We cannot provide a consumer or their agent with personal information if we cannot verify the identity of the consumer or the agent’s or the agent’s authority to make the request. I declare that all information provided here is true and correct and that I am authorized under law to make this request under penalty of perjury. I understand that Catalist may require further information to carry out my request. CAPTCHAEmailThis field is for validation purposes and should be left unchanged.