Data Privacy Data Subject Request Form

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Instructions: Please complete this form to submit a request regarding your personal data. This form allows you to exercise your rights under applicable data protection and privacy laws (such as GDPR, CCPA/CPRA, etc.). To process your request accurately and securely, we need to verify your identity and locate your information in our systems.

Section 1: Information About You (The Data Subject)

Full Name *

First

Last

Email Address *

Phone Number

Mailing Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Your Relationship With Our Organization *

Applicable Privacy Laws (if known)

GDPR
CCPA/CPRA
CPA
VCDPA
Other / Not Sure

Type of Request *

Access / Data Subject Access Request (DSAR)
Delete / Erase my personal data
Correct / Rectify my personal data
Opt-out of sale/sharing (if applicable)
Limit / Restrict processing
Portability / Export my data
Other

Applicable Verification documentation)

Request Details (describe your request and the personal data involved) *

Identity Verification (optional supporting documentation)

Drag & Drop Files, Choose Files to Upload

Consent and Acknowledgement *

I acknowledge that the information provided is accurate and that identity verification may be required to process this request.

GONEN CORP Corporate Finance

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Disclosure and Disclaimer for Gonen Capital Series Portal; This section and all content provided through the Gonen CapitaL Series Portal are for informational and educational purposes only. They do not constitute an offer to sell or a solicitation of an offer to buy any securities, financial products, or services. Any investment involves risks, and past performance is not a guarantee of future results. The information presented should not be viewed as legal, tax, or financial advice. Before making any investment decisions or financial moves, you should consult with your own legal and accounting professionals to ensure that your actions are aligned with your individual circumstances and financial goals. Gonen Capital Series Portal makes no representations or warranties, express or implied, regarding the accuracy, completeness, or suitability of the information provided.

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