OneTrust Privacy Management

Welcome to Prudential's Data Request Form!

Curious about how we protect your information?

Need additional assistance?

Please refer to our Frequently Asked Questions (FAQs) for help with your request or contact our Call Center at 1-844-PRU-DSAR (778-3727).

If you do not see the request type you are looking for, please contact our Call Center at 1-844-PRU-DSAR (778-3727).

The security of your information is of the utmost importance to us.

Prudential collects the information below solely to authenticate your identity and retrieve the requested information.

While Prudential will do all it can to honor your request, we may not be able to in certain circumstances. Please see our Frequently Asked Questions (FAQs) for more information.

If this request pertains to Long Term Care Insurance or Individual Health Insurance, please direct your request to the below email or telephone number.

HIPAA Privacy Officer at Email: HIPAAPrivacyOfficer@prudential.com

Prudential Long-Term Care Insurance

Telephone Number: 800-732-0416

Prudential Individual Health Insurance

Telephone Number: 800-828-0153

If this request pertains to your Retirement or Empower account, please direct your request to your Plan Sponsor.

If you have additional questions, please direct your request to the below email or telephone number.

PrivacyMatters@empower.com, or
Empower 855-756-4738

If this request pertains to High Peak Innovations, LLC, please direct your request to the below email:

High Peak Innovations : support@highpeak.ai

Please select your relationship with the data subject

Required

Select request type

Required

Your First Name

Enter your first name,

Your Last Name

Enter your last name.

Your Email

Enter email for correspondence with the data request.

Please confirm your Email

Your Address

Your Phone Number

Note:

The fields below should be populated with the information of the individual you are requesting on behalf of.

For the individual whose data you are requesting, please indicate the nature of their relationship to Prudential

Select the business(es)/products the individual best aligns with:

If the entity name does not appear, your request may be aligned to one of our service providers or third parties where your relationship is directly with that entity.

Individual's First Name

Enter the first name of the data subject

Individual's Middle Name

Individual's Last Name

Enter the last name of the data subject

Individual's Email

Enter the email of the individual you are submitting on behalf of

Year of Birth - YYYY

Phone Number

Enter the phone number of the data subject

Individual's Country of Residence

Enter the individual's country of residence.

Individual's State of Residence

I do hereby certify, declare, and affirm that the information I supplied is true and correct, that I am either (i) the consumer identified in this request, or (ii) authorized to make this request on behalf of the consumer. I understand that Prudential will solely rely on the information provided by me in this form to fulfill this request.

Required

Please attach legal documentation of authority (e.g., Power of Attorney, Letter of Administration, etc.)