U.S. Privacy Rights Request Form

Request received

Thank you. We've received your privacy rights request. We will contact you via the email address you provided to confirm your request and verify your identity before processing it.

In some cases, we may require additional information if we are unable to verify your request based on the information you have provided. The personal data submitted in connection with this request will be used to process your request.

* Fields marked with an asterisk (*) must be completed in order to submit this form. Complete the fields below using the consumer's information.

Consumer & requester details

Consumer's Name *

Requester's Name *

Relationship Between Consumer and Requester * (e.g., Self, Authorized Agent)

Consumer's contact information

Consumer's Email Address *

Consumer's Phone Number *

Consumer Address (including the state of residency)

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Consumer's Relationship to Outliers, Inc. * (Including the Outliers, Inc. Products and/or Services Relevant to the Request)

Type of Request

Select at least one that applies.

Right to KnowRight to confirm whether we are processing personal data about the consumer and to obtain certain personalized details about the personal data we have collected about the consumer. Right to Access & PortabilityRight to obtain access to the personal data collected about the consumer, and, where required by law, the right to obtain a copy of the personal data in a portable, and, to the extent technically feasible, readily usable format. Right to CorrectionRight to correct inaccuracies in the consumer's personal data, taking into account the nature of the personal data and the purposes of the processing. Right to Control Over Sensitive Personal DataThe right to exercise control over our collection and processing of certain sensitive personal data. Right to Opt-Out of SalesRight to direct us not to sell the consumer's personal data to any third parties. Right to DeletionRight to have us delete personal data we collected about the consumer.

Requester's contact information

Requester's Email Address *

Requester's Phone Number *

Additional Comments * (e.g., the scope of personal data involved)

Authorized Agents Only

If you're an Authorized Agent submitting a request on behalf of a consumer, you must attach written authorization from the consumer indicating you've been authorized to submit a request on the consumer's behalf. The form must be signed by both you and the consumer. All forms not signed will be rejected.

To include your signed authorization, please email it to privacy@takestasis.com after submitting this form, referencing the consumer's name and email above.

Note

You also have the right to appeal in the event that we decline to take action on a request exercising one of your rights set forth above, you have the right to appeal our decision.

By submitting this request, I am confirming the following:

Accuracy: The information I have provided is true and accurate;
Privacy: I understand the information will be processed by Outliers, Inc. and our family of companies in accordance with our Privacy Notice;
Contact: Outliers, Inc. and our family of companies have the right to contact me to verify my identity and to process this request.

Prefer email? You may also submit your request by contacting us at privacy@takestasis.com.