Employee Privacy Request Form

Are you (or the individual for whom you are submitting this request) a resident of California?

Yes

First Name

Last Name

Phone

Are you submitting this request on behalf of yourself?

Yes

What type of request are you submitting? (check all that apply)

Request to know the categories of personal information NSA has collected about the individual

Request to know the specific personal information NSA has collected and maintains about the individual

Request for NSA to delete the personal information that NSA has collected about the individual

Request for NSA to correct inaccurate personal information that NSA maintains about the individual

Are you (or the individual for whom you are submitting this request) a current or former employee, job applicant, or independent contractor of NSA?

Yes