Data Privacy Framework Application - Formstack

Company Information

Company’s full legal name (as it will appear on the Department of Commerce certification)*

List any subsidiaries to be covered under the account*

Website addresses for company and for all covered subsidiaries*

What is your company self-certifying?*

EU-U.S. Data Privacy Framework EU-U.S. Data Privacy Framework with UK Extension Swiss-U.S. Data Privacy Framework EU-U.S. & Swiss-U.S. Data Privacy Frameworks E.U.-U.S. with UK Extension & Swiss-U.S. Data Privacy Framework

Covered Data

Complaint Contact Information

Name

First Name

Last Name

Title

Address

Address Line 1

Address Line 2

City

State

ZIP Code

Phone

Email

Billing Contact Information

Name

Title

Address

Address Line 1

Address Line 2

City

State

ZIP Code

Phone

Email

Company's Total Global Revenue

Payment

Your credit card will not be charged until your privacy policy is approved and your application to the Insights Association Data Privacy Framework Services Program is accepted. You will receive e-mail notification of acceptance and charges.

Grand Total: $

Name of Company Representative:*

First Name

Last Name

Initial: (must be initialed for contract to be valid)*

Initials

Name on Card:*

Credit Card:*

Form secured by Formstack