DATA SUBJECT ERASURE REQUEST

Please complete the following form to exercise your right to be forgotten/erasure (as a Data Controller) under the General Data Protection Regulation (GDPR) and the California Consumer Privacy Act (CCPA) .

Replicon Inc. will complete this task on your behalf (as a Data Processor) and will respond promptly to your request. All data erasure requests will be completed within one (1) calendar month after the confirmation of your request.

Replicon Inc. may require further information and/or verification of your request. During this process, Replicon Inc. will confirm the request (see below) and will complete the request within one (1) calendar month.

The information supplied in this form will only be used for the purposes of identifying the personal data you are requesting to erase.

Requirements for erasure:

1. Only the authorized Primary Contact on file with Replicon Inc. is allowed to request erasure of Personal Data from Replicon Inc. systems through a signed DSER form.
2. If you’re not the Primary Contact on file with Replicon Inc., Replicon Inc. will require additional verification to confirm the validity of this request.

We will require the following for verification:

• Additional verification methods such as (and not limited to) Identification (ID) of the requestor will be required to validate your identity in your organization
• A letter from your Executive team indicating that they authorize you to submit this request on the behalf of your Company