Consumer Rights Request Form

If you are a Virginia, Connecticut or Colorado resident, you have certain rights under your state’s privacy law. Virginia, Connecticut and Colorado residents can exercise the following rights: the right to request that we provide disclosures about or access to personal data; the right to delete personal data you provide to us or that we obtain about you; the right to correct inaccuracies in your personal data; the right to access data in a portable and (if technically feasible) readily usable form; and the right to appeal a decision regarding a request.

Virginia, Connecticut and Colorado residents also have the right to opt out of the processing of their personal data for targeted advertising purposes via cookies and tracking technologies on our websites. To opt out of targeted advertising via cookies and tracking technologies, click the “Do Not Sell or Share My Personal Information” button in the footer of our websites.

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State

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First Name *

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Middle Name (optional)

Last Name *

Please fill out this field.

Select all that apply Request for disclosure (tell me about my data) Request for access (give me my data) Request for deletion (delete my data) Request for correction (correct my inaccurate data) Request for an appeal (tell me why my request was not filled)

Please select an option.

Please describe your relationship to the SCI affiliate that collected your personal data (please list all categories that apply): (e.g., pre-need or at-need contract purchaser; pre-need contract beneficiary; next of kin/family member; website visitor; other; authorized agent of any of the above):

RELATIONSHIP TO THE SCI AFFILIATE (OPTIONAL)

Additional information needed to verify your identity for request processing

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Today's Date

Please enter a valid date in this format mm/dd/yyyy.

ADDRESS 1

ADDRESS 2

CITY

STATE / PROVINCE

POSTAL CODE

Please enter a valid postal code.

CONTRACT NUMBER (IF KNOWN)

DESCRIPTION/AMOUNT OF RECENT PURCHASE (IF KNOWN)

DATE OF RECENT PURCHASE (IF KNOWN)

Please enter a valid date in this format mm/dd/yyyy.

CONTACT PHONE * +1

Please enter a valid 10 digit phone number.

CONTACT EMAIL *

Please enter a valid email.

Please indicate how you would like to receive the information requested above by checking one of the following boxes.

By Mail (at Address above) By Email (at Email above)

Please select one of these options.

Prior Information (optional)

You may also submit prior information

Prior Phone Number(s)

Prior Last Name(s)

Prior Address(es)

ACKNOWLEDGEMENT * I understand that I may make a verifiable consumer request twice within a twelve (12) month period. If I have submitted a request for deletion, I understand that, while I have the right to request deletion of my personal data, SCI or its affiliate may be able to retain some or all of the personal data for a variety of ‎reasons, such as to comply with a legal obligation.‎ I further understand that SCI or its affiliate will respond to my request as necessary using the information I provided above.

Please check this box if you want to proceed.

For more information on your rights under the VCDPA, CPA and CTDPA, please see our privacy policy.