US - PERSONAL DATA RECTIFICATION ERASURE REQUEST FORM

Complete this form to request a rectification (“correction”) or erasure (“deletion”) of personal identifiable information(“data”) about you (“the data subject”) held in our records, or on behalf of a person you are legally authorized to represent.

You are entitled to make this request under Inspiration TV’ Terms of Use and Privacy Policies, and other applicable state or national privacy protection regulations.

We will make every effort to respond within 30 days of the latest of the following:

• Our receipt of your written request; or
• Our receipt of any further information we may ask you to provide to verify your request.

The information you supply in this form will only be used for the purposes of identifying you as the authorized party to make this request, and to reference the data as you requested.

SECTION 1: Person initiating this request.

Full Name(Required)
Address(Required)
* Inspiration may need to contact you about your request.

SECTION 2: Are you the data subject?

Please tick the appropriate box and read the instructions following it.
IMPORTANT: To ensure we are releasing data to the right person you must provide proof of your identity and address. Please supply us with a photocopy or scanned image (do not send the originals) of one of the following: Proof of Identity Passport, photo driving license, national identity card, birth certificate.

If you are unable to meet the identity verification requirements, we reserve the right to refuse to grant your request.

Accepted file types: jpg, pdf, Max. file size: 40 MB.

SECTION 3: Details of the data subject (if different from section 1)

Please note: If your request is on behalf of another person, you must provide a scanned or printed copy of a duly authorized Power of Attorney to act on their behalf in the matter. If you cannot provide such a document, we must see the written consent of that person before we can fulfill your request.
Name
Address

SECTION 4: Nature of Request

Please select your desired option:(Required)
We will make every effort to provide you a satisfactory outcome if you meet all the above identification and authorization conditions, however, it is important to note that certain personal identifiable information (“data”) may not be erased in order to comply with government regulations for mandatory data retention.

SECTION 5: Declaration

Please note that any attempt to gain access to personal information through misrepresentation may result in prosecution.

I confirm that I have read and understood the terms of this request form and certify that the information given in this application to Inspiration TV is true. I understand that it is required by law for Inspiration TV to confirm my / the data subject’s identity and it may be necessary to obtain more detailed information in order to locate the correct personal data.

Please type your full legal name in the text field below. This will serve as your written approval and acceptance of these terms and conditions.

MM slash DD slash YYYY

DOCUMENT Checklist: Have you:(Required)