To process Your Verified Consumer Request, we need some basic information from You. We will only use personal information provided to verify Your identity or authority to make the request, to locate the information within our systems and respond to Your request. We cannot respond to Your request if we cannot verify Your identity or authority to make the request and confirm that the personal information relates to You. For more information, please go to Privacy Notice and Disclosure for California Residents.
Click to email us the information belowFeel free to contact us at support@coparenter.com with any other questions.
You may also copy and paste the information below into your email client, or print this page and fill it out by hand.
Postal Address:
SECTION 1: Consumer
Full Name:
Email Address Used with Co-Parenter, LLC(Required):
(note this address will also be used for correspondence relating to this request)
Phone number used with Co-Parenter, LLC:
Please provide any additional information that might be helpful in fulfilling Your request regarding how you have engaged with Co-Parenter, LLC. For example, “I purchased a product last month.”:
SECTION 2: Are you the Consumer who is the subject of this Request?
[ ] YES, I am the Consumer that is the subject of this Request.
[ ] NO, I am the Authorized Agent acting on behalf of the Consumer that is the subject of this Request. If NO, please go to section 3.
SECTION 3: Details of Authorized Agent
If this request is on the behalf of the Consumer, upload either a copy of a power of attorney provided by the Consumer pursuant to Probate Code sections 4121 to 4130 or proof of signed permission along with a copy of the Authorized Agent’s ID. If a power of attorney is not provided, the Consumer will be required to confirm with us directly that they provided permission to submit the request.
(Please attach a copy of any power of attorney or proof of signed permission)
SECTION 4: Nature of Request
Please select all desired options:
[ ] Specific pieces of personal information that Co-Parenter, LLC has collected about You. (This request requires filling out Section 5 to specify the method you want to receive the specific pieces of information. Please also complete the declaration in Section 6 to finalize this request.)
[ ] Deletion of Your personal information.(Please complete the declaration in Section 6 to finalize this request.)
[ ] Categories of Consumer personal information Co-Parenter, LLC has collected about You.
[ ] Categories of sources from which Your personal information is collected.
[ ] Categories of Your personal information that Co-Parenter, LLC sold or disclosed for a business purpose.
[ ] Categories of third parties to whom Your personal information was sold or disclosed for a business purpose.
[ ] The business or commercial purpose for collecting or selling Your personal information
SECTION 5: Delivery Options
The e-mail address you provided in Section 1 will be used for correspondence relating to this request. If you made a request to know specific pieces of information you can receive the information electronically or by mail. If you elect to receive the information by mail please provide your mailing address.
[ ] Mail Delivery – provide mailing address
[ ] Electronic Delivery
SECTION 6: Declaration
The following CCPA requests require you to submit a signed declaration under penalty of perjury that you are the consumer whose personal information is the subject of this request.
* Right to Know – Specific Pieces of Personal Information
* Deletion Request
Please complete the below declaration as required so that we may fulfill your request made pursuant to CCPA.
Declaration in Support of Verified Consumer Request
I. Choose Request Type:
[ ] Right to Know – Specific Pieces of Personal Information
[ ] Deletion Request
I acknowledge that I am a California resident and the person making the request noted above, under the California Consumer Privacy Act. I acknowledge that I am making this request in good faith on behalf of myself.
I certify and declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Declarant Signature
Print Name
Date