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In the Shop
In the Kitchen
On the Calendar
Shop Online
About Us

Data Subject Access Request Form

Please fill in the information below. The website administrator will be notified of your request, and will need an appropriate amount of time to respond.

Name *

First and Last

What email address do you use to access House & Hazel? *

You are submitting this request as *

The person, or the parent / guardian of the person, whose name appears above.
An agent authorized by the consumer to make this request on their behalf.

Under the rights of which law are you making this request? *

If submitting under GDPR; I am submitting a request to…

Confirm that my personal information is being processed
Access my personal information
Edit / correct my personal information
Have my personal information deleted
Restrict the processing of my personal information
Ask a question about House & Hazel’s privacy policy
Withdraw my consent to the processing of my personal information
Deny House & Hazel the right to use my personal information for purposes of direct marketing, including profiling
Other (please specify in the comment box below)

If submitting under CCPA; I am submitting a request to…

Know what information is being collected from me
Have my information deleted
Opt out of having my data sold to third parties
Opt in to the sale of my personal data
Access my personal information
Fix inaccurate information
Receive a copy of my personal information
Opt out of having my data shared for cross-context behavioral advertising
Limit the use and disclosure of my sensitive personal information
Other (please specify in the comment box below)

If submitting under CPA or CTDPA; I am submitting a request to…

Know what information is being collected from me
Have my personal information deleted
Opt out of having my data sold to third parties
Opt out of data processing for targeted advertising
Opt out of data processing for profiling
Access my personal information
Fix inaccurate information
Appeal a data request decision
Other (please specify in the comment box below)

If submitting under UCPA; I am submitting a request to…

Know what information is being collected from me
Have my personal information deleted
Opt out of having my data sold to third parties
Opt out of data processing for targeted advertising
Access my personal information
Other (please specify in the comment box below)

If submitting under VCDPA; I am submitting a request to…

Know what information is being collected from me
Have my personal information deleted
Opt out of having my data sold to third parties
Opt out of data processing for targeted advertising
Opt out of data processing for profiling
Access my personal information
Fix inaccurate information
Appeal a data request decision
Other (please specify in the comment box below)

Please leave details regarding your action request or question. *

I confirm that *

Under penalty of perjury, I declare all the above information to be true and accurate.
I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with House & Hazel.
I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.

In the Shop
In the Kitchen
On the Calendar
About Us
Privacy Policy
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In the Shop
In the Kitchen
On the Calendar
About Us
Privacy Policy
Terms and Conditions

House & Hazel is a furniture and homegoods store as well as a wine bar located in Maple Valley, Washington.

23631 Maple Valley Black Diamond Rd SE, Maple Valley WA, 98038

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