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Consumer Privacy Rights Request Form

If you are a resident of California, Colorado, Connecticut, Virginia or Utah, you may be able to make a data deletion request or information disclosure and/or correction requests by indicating below, and providing the requisite information. For additional discussion of your privacy rights, please visit our Privacy Policy by Clicking Here.

First Name

Last Name

Last 4 digits of your SSN

Email Address

DOB

Phone

(

)

Street Address

City

State

Postal Zip Code

Please select one or more actions desired.

Information Disclosure Request (where we collected your information from, to which parties we shared it with and the associated business purpose).

Data Deletion Request.

Information Correction Request (you can request that we correct the personal information that we have on file for you).

Describe your correction request, if any, with sufficient detail that allows us to properly understand, evaluate and respond to it:

Security Code:

Users with disabilities (and any other users) who wish to make a data deletion request or information disclosure and/or correction can also contact us by emailing us at: privacy23@capitalcashassistancedirect.net or sending us mail to: 539 W Commerce St #5941, Dallas, TX 75208.
If we have a good-faith, reasonable and documented belief that a request to opt-out is fraudulent, we may deny the request.
Where you make a request to delete, disclose, or correct your personal information through an authorized agent, we will require that you or the authorized agent provide us with a valid written authorization executed by both parties, with the validity of such document determined by us in our reasonable, good faith, discretion. Please submit such documentation to us at: privacy23@capitalcashassistancedirect.net or sending us mail to: 539 W Commerce St #5941, Dallas, TX 75208.