Privacy Policy Form - NXT Capital

Are you making the request on your own behalf or on behalf of another individual?(Required)

On behalf of another individual

On your own behalf

Provide your own contact information:

Full Name(Required)

Email Address(Required)

Address(Required)

Phone Number(Required)

Please provide any documentation supporting the basis of your authorization, e.g., as applicable, a power of attorney and/or signed permission that a California resident has authorized you to make a request.(Required)

Max. file size: 100 MB.

Answer the remaining questions on behalf of the individual for whom you are authorized to make the request.

Full Name(Required)

Email Address(Required)

Address(Required)

Phone Number(Required)

Are you a resident of California?(Required)

Yes

What is your relationship to NXT?(Required)

Website visitor

Customer

Employee or job applicant

Other

If other, how would you describe your relationship to NXT?(Required)

What type of request do you want to make?(Required)

I would like to know what kinds of personal information NXT has collected, used, and disclosed about me.

I would like NXT to provide me with copies of the personal information NXT has collected about me.

I would like NXT to delete the personal information it collected from me.

I would like NXT to correct the inaccurate personal information it maintains about me.

877-NXT-6111 info@nxtcapital.com

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