CCPA Consumer Request

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

Consumer Request Form

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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 with legitimate business purposes, such as preventing fraud or avoiding overpayment of benefits to deceased individuals. Where personal information is provided to PBI by client organizations, PBI is a service provider or contractor to such organizations. As the business and controller of personal information related to you, your pension plan, insurance company, or other business is the proper entity to address any questions or requests related to your personal information.

If PBI is 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, and deletion 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. 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.

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Type of Request

Access to specific information

Data portability rights

Deletion

Request Details*

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California

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Consent*

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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.

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