Data Subject Access Request Form

Website URL
Your name
What email address do you use to access the above website / app?

You are submitting this request as
The person, or the parent / guardian of the person, whose name appears above.
An agent authorized by the consumer to make this request on
Under the rights of which law are you making this request?
CCPAGDPROther
I am submitting a request to
Know what information is being collected from meHave my information deletedOpt out of having my data sold to third partiesOpt in to the sale of my personal dataOther (please specify in the comment box below)
Please leave details regarding your action request or question.


I confirm that
Under penalty of perjury, I declare all the above information to be true and accurate.
I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with Rubber E Mart.
I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.