CCPA Consumer Request

Pension Benefit Information, LLC
333 South Seventh Street
Suite 2400
Minneapolis, MN 55402
www.pbinfo.com

Consumer Request Form

Pension Benefit Information, LLC (“PBI” or “we”) works with pension plans, insurance companies, financial institutions, government entities, benefit plan sponsors, and other clients to help locate people who may be eligible for benefits. We also help our clients prevent fraud or avoid overpayment of benefits to deceased individuals. If we are trying to reach you for one of these purposes, by submitting this form, you may make it more difficult for your former employers, pensions, and unions, to locate your contact information and communicate with you regarding your benefits. Consumer requests under the California Consumer Privacy Act (“CCPA”) are only available to California residents as described in the CCPA. Only you, or a person registered with the California Secretary of State that you authorize to act on your behalf, may make a verifiable consumer request related to your personal information. You may also make a verifiable consumer request on behalf of your minor child. PBI is not obligated to provide information to you if we cannot verify your request (i.e., we cannot associate the information you provided in your request to any personal information previously collected by PBI about you). To exercise the access, data portability, deletion, and opt-in rights described in our Privacy Notice for California Residents, please submit this verifiable consumer request form to us by either:
- Completing it online, or
- Calling us at 1-800-327-2720 to provide the above information.
You may only make a verifiable consumer request for access or data portability twice within a 12-month period. You may submit an opt-out request by submitting an opt-out request online here or by calling 1-800-327-2720. For more information on PBI’s collection and use of California residents’ personal information and California residents’ rights under the California Consumer Privacy Act, please review PBI’s Privacy Notice for California Residents.
Name*
First Last
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Date of Birth*
Month
Day
Year
Last 4 Digits of Social Security Number (SSN)
Please enter a number from 0000 to 9999.
Type of Request
- Access to specific information
- Data portability rights
- Deletion
- Opt-in
Request Details*
Please contact me using the*
- email
- mailing address provided above
I certify that I am a resident of:
California
or, I certify I am a resident of:
Consent*
- By submitting this form, I certify that I am making this request on behalf of myself; or
- By submitting this form, I certify that I am authorized to make this request on behalf of the person whose information is listed above. Note, that an authorized person may be required to submit proof of authorization.