Request Form to Access or Delete Personal Information of a California Resident

Instructions: California Residents can use this form to submit requests to Venable LLP ("Venable") to delete or provide access to personal information that we have collected, under the California Consumer Privacy Act (CCPA). In each case, we will respond to such requests to the extent required by law.

We may ask for additional information or documents to verify the identity of the individual who is the subject of the request and to verify that an agent submitting a request on behalf of the individual is authorized to do so. The information provided through this form will be used only to respond to your request, such as for verifying your identity, identifying personal information responsive to your request, and keeping records of your request.

1. Details of the Individual

Please select one of the following:

I am current client (including a contact of a current business client) of Venable. I am former client (including a contact of a former business client) of Venable. I have never had a relationship with Venable. I have worked for, or applied for employment with, Venable.

If you do not have a prior or current relationship with Venable LLP, please provide us with any additional details that may be helpful in locating your personal information:

Please provide the following information:

First Name *

Last Name *

Email Address *

Telephone Number *

State of Residence *

Name of Business

Rights under the CCPA are available only to California residents.

2. Details of the Person Requesting the Information

Only complete this section if you are making this request on behalf of the individual referenced above.

Full Name

Email Address

Please describe your relationship with the individual:

3. Nature of the Request(s)

Check all that apply.

I would like to know categories of personal information Venable has collected, used, and disclosed about the individual. I would like to delete personal information Venable has collected about the individual. I would like to obtain specific pieces of information Venable has collected about the individual.

Declaration

I certify that the information given on this application form to Venable is true and complete, and that I am the individual who is the subject of the request or have been authorized by the individual to act on his/her behalf, as indicated above. I understand that it is necessary for Venable to verify my/the individual’s identity and/or to verify that I am the authorized agent for this request, and it may be necessary for Venable to obtain more detailed information in order to complete the verification and/or locate the correct information.

For requests submitted by an authorized agent, you must email a written, signed permission from the individual to privacy@Venable.com showing that the individual has authorized the agent to make the request.