CooperCompaniesCooperVision, Inc.Paragon Vision Sciences, Inc.Blanchard Vision Corp. Please complete this form if you wish to request either (check one or both) Access to your personal data Deletion of your personal information Completing this form will help us to address your request quickly and effectively. You can also contact us at (855) 526-6737. You can also use this form if you are requesting access to personal data on behalf of someone else. In that case, we will need you to confirm you have that person’s authority to ask for access to their data. If you have any questions about this form or your request, please contact dpo@coopervision.com. 1. Information About you Please provide the following information. If you have an account number or other reference number, please provide it. Full name * Address Email address * Telephone number Add additional information such as customer account number, client number For security reasons, we cannot respond to a request until we are able to verify your identity. Please send to us: A copy of your driver’s license, passport or other valid government-issued photo i.d. Plus one (1) of the following: Proof of your mailing address (e.g., a utility bill) you provided to us as part of your personal information The phone number you provided to us as part of your personal information The email address you provided to us as part of your personal information; or Any other information you provided to us as part of your personal information Please send the above information as soon as possible to: By mail: CooperVision, Inc. Legal Department 6101 Bollinger Canyon Rd #500 San Ramon, CA 94583 2. Whose personal data are you requesting? Please provide the following information. If you are making this request on behalf of someone else, we will need the additional information in Section 2.2 before we can respond to your request. 2.1 Are you requesting access to your own personal data? Yes, please go to Section 3 below. No, please complete the information in Section 2.2. 2.2 If you are not requesting access to your own personal data, please provide the following information about the person on whose behalf you are making this request: Full name Address Telephone number Email address Other information (such as customer account number, etc.) Age (if under 16) For security reasons, we cannot respond to a request until we are able to verify the identity of the person you are making the request for, as well as confirming that you are authorized to request such information on the individual’s behalf. Please send to us: A copy of the individual’s driver’s license, passport or other valid government-issued photo i.d. Plus one (1) of the following: Proof of the individual’s mailing address (e.g., a utility bill) he, she or they provided to us as part of his, her or their personal information The phone number the individual provided to us as part of his, her or their personal information The email address the individual provided to us as part of his, her or their personal information; or Any other information the individual provided to us as part of his, her or their personal Please provide a copy of your legal authority to make this request. This might be a signed letter of authority from the person on whose behalf you are making this request, a power of attorney, or confirmation that you are their legal representative. Please send the above information as soon as possible to: By mail: CooperVision, Inc. Legal Department 6101 Bollinger Canyon Rd #500 San Ramon, CA 94583 3. What data are you requesting? Your rights to request access to personal data and other information are set in our California Privacy Policy. Please describe what personal data and other information you are requesting access to or deletion of. Description of the personal data and information requested including details of any specific documents or information you are asking for (where relevant) 4. Acknowledgment Please complete the fields below: Print Name Here: * Date Form Completed * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20202021202220232024 By clicking this box, I acknowledge that the information I have provided is truthful and accurate. * Acknowledgment Leave this field blank