Consumer Data Requests

Name: *

Company:

Street:

City:

State:

Zip:

State Of Residence: *

Country Of Residence: *

Email: *

Phone Number: *

Describe your request (check all that apply): *

I want to know what categories of my personal information PGM has collected about me.

I want to know what specific pieces of my personal information PGM has collected about me.

I want to know the business or commercial purpose PGM has for collecting or sharing my personal information with other entities.

I want to know the categories of the sources from which my personal information was collected.

I want to know the categories of external parties with whom PGM shares my personal information.

I want PGM to delete my personal information. NOTE: The deletion of your personal information requires a two-step process to confirm your request to delete. Please also note that deleting your personal information could impact your ability to receive products and services from PGM in the future.

I want PGM to provide me with my personal information for portability purposes.

I want to withdraw my consent for PGM to process my personal information.

Other

If other request (please describe):

The following boxes indicate your understanding and acknowledgement of the following conditions and must be checked for PGM to process your request(s).

Acknowledgments: *

I understand and acknowledge that PGM will process the information provided in this form for the purposes of carrying out my request(s) as indicated above.

I understand and acknowledge that submitting this form does not guarantee PGM will be able to fulfill my request. I further understand and acknowledge that failure to properly complete this form could impact PGM’s ability to respond to my request.

I acknowledge that as of the date that I am submitting this form, I am eighteen (18) years of age or older.

Information regarding PGM’s privacy practices may be found in our Privacy Policy.

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Closed: 12-23-24 to 01-03-25

Data Access Request Form

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