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V12 Individual Opt-out Form

Your opt-out request is very important to us and we will process the removal of your information with deliberate speed. (No longer than 10 business days) Please provide us with the following information which we will only use to remove your name, address, phone and/or email information from our databases.

Once submitted, V12 will remove your data from V12's databases. Once your data is removed, it is no longer available for access by any third party.

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

First Name

Middle Initial

Last Name

Address 1 [include Apt# if applicable]

City

State

Zip

Email Address:

Phone

Today’s Date: [MM/DD/YYYY]

If you have any questions, you can email us: privacy@v12data.com or send correspondence to:

V12 Attention: Privacy Advocate
2319 Oak Myrtle Ln, Suite 104
Wesley Chapel, FL 33544

V12’s On-line Opt-out Request Process is intended for individual consumer use.