Personal Information Request

If you are a California resident, you may submit a request relating to your personal information. Please refer to our Privacy Policy for more information. The information you provide below will be used by Wawanesa to verify and respond to your request.

*Indicates a required field

Is this request for you or on behalf of someone else?

Are you a current Wawanesa customer?

What are you requesting?

Your information

State of residence

Country of residence

captcha image
Play Captcha Audio
Refresh Captcha

To confirm that you are not a bot, please enter the characters shown in the above image:

By signing and clicking below, you confirm that the information you have provided in this form is accurate, that the request is by or on behalf of the individual specified above, and that you are authorized to submit this request.