Request Mydata

I, the undersigned individual, do hereby swear, certify, and attest that

I am a citizen and/or resident of

Phone

I own and operate one or more mobile devices with the following Device Identifier(s) (as that term is used in the Octillion Data Subject Rights Notice):

(###)

###

####

Connected Device

Mobile

Browser

I have the authority under relevant laws, rules, and regulations, to submit a subject access request for personal data associated with the above-listed identifiers; and

I am not requesting this information for any fraudulent, criminal, malicious, or otherwise unlawful purpose.

I declare under penalty of perjury that the foregoing is true and correct.

Name

First Name

Last Name