Personal Information Request

At Jerry, we are committed to your privacy and online security. Please see our Privacy Policy to learn more. As explained in our Privacy Policy, a number of states provide residents with certain rights with respect to their personal information/data. If you’d like to submit a personal information request, please fill out the form below.

Full Name *

Phone Number *

Email *

Street Address *

Apt, Suite, Unit (optional)

City *

State *

ZIP Code *

Please select the applicable box: *

I certify that I am a resident of California, Colorado, Connecticut, Delaware, Florida, Indiana, Iowa, Minnesota, Montana, Nebraska, New Hampshire, New Jersey, Oregon, Tennessee, Texas, Utah, or Virginia, submitting this request for myself. I certify that I am an authorized agent submitting this request on behalf of a resident of one of the states listed above. I may be required to submit proof that I have been duly authorized to act on their behalf.

Please select the applicable box(es): *

I would like to know the categories of personal information collected about me in the preceding 12 months. I would like to receive a copy of the personal information collected about me in the preceding 12 months. I understand that certain information will not be disclosed to me, even if my personal information request is verified, such as a social security number, driver’s license number or other government-issued identification number, financial account number, or account password. I also understand that Jerry is not required to disclose specific pieces of personal information to me, as opposed to categories, unless I provide a written declaration under penalty of perjury stating that I am the consumer whose personal information is the subject of this request. If you select this option, we will contact you regarding the required declaration. I would like to correct inaccurate personal information collected about me. I understand that I can edit much of my personal information through my Jerry account. I also understand that Jerry is not required to comply with my request unless I provide necessary documentation to rebut Jerry’s own documentation that the personal information is accurate. If you select this option, we will be in touch with you about the specific information you wish to correct and the required documentation. I would like the personal information collected about me to be deleted.

Please note that certain personal information you may have provided or that we have collected about you may not be subject to your personal information rights under state law and that, as a result, we may not honor all requests. For more information, please see our Privacy Policy.

By submitting this request, I certify that I have reviewed this form in its entirety and all information on this form is true and correct.