Name: DataDelivers
Address: 100 w. Hillcrest blvd. ste 406, Schaumburg, Illinois, 60195

Individual Delete Form

Your delete request is very important to us and we will process the removal of your information with deliberate speed. Please provide us with the following information which we will only use for identification/matching purposes in our databases.

I certify that the information provided below relates to a single identity and is one of the following:*
- Myself
- An Individual for whom I have legal guardianship or power of attorney
- A deceased member of my family
Name*
First Name Middle Initial Last Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Phone*
Signature*
Today's Date*
MM slash DD slash YYYY
If you have any questions, you can email us at marketing@datadelivers.com or send correspondence to:

DataDelivers
100 W. Hillcrest Blvd., Ste. 406
Schaumburg, IL 60195

DataDelivers’s online delete request process is intended for individual consumer use
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