California Consumer Privacy Act Request Form

Please complete this form and submit to United Capital Financial Advisers, LLC. Your request will be acknowledged within 10 business days.

Name*

Date of Birth*

Email Address*

Phone Number*

Physical (legal) Address*

City*

State*

Zip Code*

Are you a Client?*

Select an Answer Yes No

Name of Your Advisor*

I would like to know what specific information you have collected about me within the past 12 months.

I would like you to delete personal information you have collected about me.

I would like the information about the categories of personal information you collect or disclose about me.

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Submit