Privacy Rights Request Form

Privacy Rights Request Form
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Location*
State*
Specify your request
Please specify your request*

I want to access the Personal Information that Retail Food Group holds about me.I want to rectify inaccurate or incomplete Personal Information that Retail Food Group holds about me.I want to request the deletion of my Personal Information held by Retail Food Group.I want to restrict the processing of my Personal Information under certain conditions.I want to receive my Personal Information in a structured, commonly used, and machine-readable format, and/or request that Retail Food Group transmit this data to another data controller.I want to object to the processing of my Personal Information, including profiling or direct marketing, under certain conditions.I want to request not to be subject to a decision based solely on automated processing, where it produces a legal or similar effect (including profiling).I have a complaint or another specific request regarding my Personal Information.
Correction of Personal Information*
Please specify the information that needs to be corrected.
Restriction of Processing Information*
Please specify the restrictions you'd like placed on the processing of your Personal Information
Please specify your request (United States)*

Access to Personal Information - I want to access the Personal Information that GJC USA holds about me.Correction of Personal Information - I want to rectify inaccurate or outdated Personal Information that GJC USA holds about me.Deletion of Personal Information - I want to request the deletion of my Personal Information held by GJC USA.Data Portability - I want to request to obtain a copy of my Personal Information provided to GJC USA in a form that is easy to use and transfer.Opt-Out - I want to opt out of the sale or sharing of my Personal Information by GJC USA.Limit Use and Disclosure - I want to limit the use and disclosure of sensitive Personal Information collected about me.Complaints or Other Requests - I have a complaint or another specific request regarding my Personal Information.
Additional information about your request (optional)

If you feel there is additional information that you would like to provide us to assist us in the processing of your privacy request and/or verification of your identity, please add those details below. DO NOT provide your credit card number, or other sensitive Personal Information.
Additional Information
Declaration
I declare that the information provided in this form is accurate and that I am the individual to whom the Personal Information relates.*

Yes
PLEASE NOTE: We will send you an acknowledgement email once we have reviewed your request. Please review it carefully because we may need to request more information from you to process your request if we are unable to identify you in our systems with the above information. We have 30 or 45 days to respond (subject to applicable law), from the date we receive your fully completed request and your identity is verified. In certain circumstances, we are allowed to deny your request or limit the information we provide. If so, we will let you know in writing our reasons for such denial or limitation.
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Privacy Rights Request Form

Specify your request

Additional information about your request (optional)

Declaration