Data Privacy Complaint Form
What is the Complaint About? Check all that apply
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The company failed to adequately respond to my request to know the data being processed.
The company failed to correct inaccurate information after I requested a correction.
The company failed to provide a copy of my data as requested.
The company failed to adequately respond to my request to delete my data.
The company failed to comply with my request to opt out of targeted advertising, sale of data, or profiling.
The company failed to respond to my request for information about the company’s profiling decision(s).
The company failed to respond to my correspondence objection to their profiling decision, or failed to provide me with information about what I could have done or do differently to obtain a different profiling decision.
The company failed to respond to my request to know whether data has been disclosed, and to what other entities it has been disclosed.
The company has failed to respect my request for it to not process sensitive data.
The company has failed to comply with a universal opt-out request.
The company is trying to get my consent unlawfully (such as using confusing or tricky language or dark patterns).
There are concerns about my child’s privacy.
The company has made it difficult or impossible to submit a privacy request to it.
Don’t know/not sure
Other
YOUR INFORMATION
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
Confirmation Email
example@example.com
Are you a parent or legal guardian filing a complaint on behalf of a child or another person?
*
Yes
No
INFORMATION OF CHILD OR INDIVIDUAL
If you are a parent or legal guardian filing a complaint on behalf of a child or another person, please provide their information below.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
Confirmation Email
example@example.com
Confirm Email Address
example@example.com
ORGANIZATION ABOUT WHICH YOU ARE COMPLAINING
Company Name
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Website
*
DESCRIPTION OF THE PROBLEM
Please describe the problem.
FILE UPLOAD
It is not mandatory for you to upload files for this Office to review your complaint, but if you don’t send us certain files for us to look at, it may be difficult for us to enforce the law and get the result you want. The files that would be most helpful to us are copies of correspondence that you and the organization have sent to each other about your request to exercise your privacy rights, starting with your initial request, and screenshots or URLs of non-compliant webpages.
File Upload
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of
By choosing Accept below, I consent to and acknowledge that the information I am providing may be used and/or disseminated by the Minnesota Attorney General’s Office: (a) to resolve the issue about which I am contacting the Office, including by contacting any person or entity complained against; (b) to communicate with me; (c) to other law enforcement agencies and/or consumer-assistance agencies; and (d) to otherwise assist in enforcing the law. Except as otherwise authorized by this consent, I understand that the information I am providing will be treated as “private data on individuals” under the Minnesota Government Data Practices Act, Minn. Stat. ch.13, and shall not be used or disseminated except as authorized under the Act or other applicable state or federal law. I understand that I am not legally required to provide the information I have submitted in this form, but that my failure to do so may make it more difficult to resolve my concern.
*
Accept
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