Name *

First

Last

Email *

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 their behalf.

Under the rights of which law are you making this request? *GDPRCCPAOTHER

I am submitting a request to ___________ *

• Know what information is being collected from me
• Have my information deleted
• Opt out of having my data sold to third parties
• Opt in to the sale of my personal data
• Other (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 Microbira.
• I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.

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