CCPA Request Form

California residents can use this form to submit requests under the California Consumer Privacy Act (CCPA) regarding personal information collected by DebtNegate.com. Much of the personal information that DebtNegate.com collects is exempt from the CCPA because it is protected under other federal and/or state financial privacy laws. NerdWallet reserves the right to refuse requests, in part or in whole, to the extent permitted by law, if we are unable to verify your identity, or if we cannot verify your authority to act on behalf of another person.

Please keep in mind, for certain requests, we may ask for additional information or documents to verify the identity of the consumer who is the subject of the request. The information provided through this form will be used to respond to your request, including verifying identity, identifying personal information responsive to your request, and keeping records of your request.

Fill Out The Form Below to Start Your Request

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1. Requestor Information

Name

First

Last

City and State of Residence

2. Are You the Consumer?

Multiple Choice

Yes, I am Making a Request Related to Personal Information About Me
No, I am Acting as an Authorized Agent for the Consumer. I have Enclosed a California Authorized Agent Designation Form Completed & Signed by the Consumer

Name

First

Last

City and State of Residence

4. Request for Online Activity Information

If your request applies to online activity information that DebtNegate.com may have collected through cookies or similar technologies, you must make your request from the browser or device that you have previously used to access DebtNegate.com’s websites or apps. This has to be done so we can read any identifier that we have assigned to your browser or device.

5. Specify the Request(s)

Check All That Apply

Request to Know Categories of Personal Information DebtNegate.com has Collected, Used and/or Disclosed About the Consumer
Request to Obtain Specific Pieces of Personal Information DebtNegate.com Collected About the Consumer
Request to Delete Personal Information DebtNegate.com Has Collected From the Consumer

6. Declaration

BY SIGNING BELOW, I HEREBY CERTIFY THAT THE INFORMATION ENTERED INTO THIS FORM IS COMPLETE, ACCURATE AND UP-TO-DATE, AND THAT I AM THE CONSUMER WHO IS THE SUBJECT OF THE REQUEST OR HAVE BEEN AUTHORIZED BY THAT CONSUMER TO ACT ON HIS/HER BEHALF, AS INDICATED ABOVE. I UNDERSTAND THAT IT MAY BE NECESSARY FOR NERDWALLET TO VERIFY THE IDENTITY OF THE CONSUMER AND/OR AUTHORIZED AGENT FOR THIS REQUEST, AND ADDITIONAL INFORMATION MAY BE REQUESTED FOR THIS PURPOSE.

Signature

**Drag Your Mouse Along to Sign Your Name**