CONSUMER RIGHTS REQUEST FORM

In accordance with applicable U.S. privacy law, and depending on the jurisdiction in which you reside, you may be able to exercise certain data rights regarding your personal information. Please complete this form to submit your request. For more information about these rights, please see our Privacy Policy.

In certain circumstances, we may require additional information if we are unable to verify your request based on the information you have provided. We collect this information to verify your identity and locate your personal information in our systems. We use this information only to fulfill and respond to your request.

* Fields marked with an asterisk (*) must be completed in order to submit this form. Complete the fields below using the consumer’s information.

Identify your relationship with Carrix, Inc. and related entities:

Web Visitor

Customer

Job Applicant

Authorized Agent

Other

Select the Consumer Right you would like to exercise:

Right to Access and Portability: The right to obtain access to the personal information we have collected about you and, where required by law, the right to obtain a copy of the personal information.

Right to Know: The right to confirm whether we are processing personal information about you, and under California law only, the right to know the categories of personal information we have collected about you.

Right to Request Deletion: The right to request deletion of personal information we have collected from you, subject to certain exceptions.

Right to Correction: The right to request that any inaccuracies in your personal information be corrected, taking into account the nature of the personal information and the purposes of the processing of your personal information.

Note that you also have the right to appeal in the event that we decline to take action on a request exercising one of your rights set forth above.

Name

First Name

Last Name

City

State

ZIP Code

Email Address

Alternate Email Address

Phone Number

(###)

###

####

Alternate Phone Number

(###)

###

####

Authorized Agents only:

If you’re an Authorized Agent submitting a request on behalf of a consumer, you must also provide a written authorization from the consumer indicating you’ve been authorized to submit a request on the consumer’s behalf by emailing the form to Privacy@Carrix.com. The form must be signed by both you and the consumer. All forms not signed will be rejected.

By submitting this request, I am confirming the following:

(1) Accuracy: the information I have provided is true and accurate;

(2) Privacy: I understand the information will be handled by Carrix in accordance with its Privacy Policy;

(3) Contact: Carrix has the right to contact me to verify my identity and to process this request.