Agent Authorization Form

If you are a California resident, you have the right to authorize someone else to request that we provide access to or delete your personal information. If you would like to authorize someone to submit a request, please complete this form.

The authorized person must submit this completed form along with the request.

A. Your Name and Contact Information

First Name

Last Name

Email Address

Phone Number

B. Authorized Person’s Name and Contact Information

First Name

Last Name

Email Address

Phone Number

I authorize the agent identified above to submit a disclosure request or deletion request on my behalf. I understand that by providing this authorization, the authorized person can submit requests to Cushman & Wakefield to delete and/or to obtain disclosure of my personal information and that Cushman & Wakefield may comply with those requests without my further input. I understand that I can revoke this authorization at any time by contacting Cushman & Wakefield at privacynorthamerica@cushwake.com or +1-844-339-8836.

By submitting this form, you agree to the terms noted above.

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