Home - LexisNexis Risk Solutions Consumer Disclosure

Electronic Request Form

You may order information on yourself or someone whom you have legal authority over, such as a minor. If you are ordering information for someone other than yourself, you will need to submit paperwork to prove you have authorization. Please call to speak to a live LexisNexis Risk Solutions Consumer Center representative at 1-888-497-0011 or contact us by email at consumer.documents@LexisNexis.com.

To submit a request using the Consumer Request Form, you are required to provide your First Name, Last Name, Street Address, City, Zip, and Date of Birth. You are also required to provide one of the two following optional fields: Social Security Number or Your Driver’s License Number and State. The information that you provide will only be used by us to verify your identity and for consumer disclosure purposes. It will not be provided or sold to any other company. 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.

For more information on submitting a request using this secure form view the Electronic Request Form Instructions .

Please complete all of the sections on the form so that we may properly process your request.

*required ⁺At least one is required

First Name

Middle Name

Last Name

Suffix

Resident Address

Street Address

City

State

Zip

My Delivery Address is Not the Same as My Resident Address

SSN

Phone

Date of Birth*

Driver's License Number

Driver's License State

Additional Options for California Residents

As a California resident, you have additional options under the California Consumer Privacy Act (CCPA). To request any of the following options, please select the check boxes:

Do Not Sell My Personal Information
Do Not Sell My Professional Healthcare Information (Healthcare Professionals Only)
Delete My Personal Information

Notice of Right to Opt-Out: A Do Not Sell My Personal Information request, sometimes referred to as an opt-out request, will prevent your personal information from being sold to a third party. If you are a professional healthcare provider, we offer a separate opt-out option in the event you want your professional healthcare information to continue to be sold but not personal information in your individual capacity. An opt-out request will not apply to information that is exempt from the CCPA. For more information, or for additional methods to submit an opt-out request see the California Consumer Privacy Act Homepage.

Request My Information

Select Request My Information to request a copy of your information. California residents will receive both their LexisNexis® Risk Solutions Consumer Disclosure Report and their California Consumer Privacy Act Report.

Email is optional but must be provided and verified to include email-linked data in your report.

Consumer Portal

Electronic Request Form

Resident Address

Delivery Address (Mailing Address)

Additional Options for California Residents

Acknowledgment Message