Thank you for your request. It has been received and is under review.
You may be required to submit proof of your identity for certain requests to be processed. Such information may include your First Name, Last Name, Street Address, City, Zip, and Date of Birth, and either your Social Security Number or your Driver’s License Number and State. This information will be used only for the purpose of verifying your identity and processing your request. We may not be able to comply with your request if we are unable to confirm your identity or to connect the information you submit in your request with personal information in our possession. Please read all instructions on this page before completing this form. To request an Opt-Out or Opt-in, complete all required fields identified with an asterisk (*).
If you believe you may qualify as a covered person under Daniel’s Law, please contact the Consumer Center at 888‑497‑0011 for assistance.
Note: You must be at least 16 years of age to submit this form. You may choose as many or as few options to Opt-Out or Opt-In as you prefer.
See our privacy page for additional rights you may have in your state.