OPT-OUT REQUEST FORM

Section 1: Data Subject Information

Please provide your personal details so we can identify and process your request accurately.

Section 2: Type of Consent Being Withdrawn / Opt-Out Request

A. Marketing Communications

B. Data Processing Activities

C. Right to Restriction or Erasure

Section 3: Reason for Opting Out (Optional)

Section 4: Declaration and Signature

I understand that my request may affect my ability to access some services offered by ZICB.