Verified Consumer Request Form

To process Your Verified Consumer Request, we need some basic information from you. We will only use personal information provided to verify your identity or authority to make the request, to locate the information within our systems and respond to Your request. We cannot respond to your request if we cannot verify Your identity or authority to make the request and confirm that the personal information relates to you.

For more information, please visit our Privacy Notice.

"*" indicates required fields

First Name*

Last Name*

Email*

(note: this address will also be used for correspondence relating to this request)

Phone

Please provide any information that might be helpful in fulfilling Your request regarding how you have engaged with Buc-ee's. For example, “I purchased a product last month”

Are you the consumer who is the subject of this request?*

Yes, I am the consumer that is the subject of this request

No, I am the Authorized Agent acting on behalf of the consumer that is the subject of this request.

If this request is on the behalf of the Consumer, send either a copy of a power of attorney provided by the Consumer pursuant applicable state law or proof of signed permission along with a copy of the Authorized Agent’s ID to consumerrequest@buc-ees.com. If a power of attorney is not provided, the Consumer will be required to confirm with us directly that they provided permission to submit the request.

Nature of Request*

Access to personal information that Buc-ee’s has collected about You.

Deletion of Your personal information.

Correction of Inaccuracies in Your Personal Information

Opt-Out of Processing Of Personal Information

Please select all the desired options

Delivery Options

Mail Delivery – Provide Mailing Address

The e-mail address you provided above will be used for correspondence relating to this request. If you made a request to know specific pieces of information you can receive the information electronically or by mail. If you elect to receive the information by mail please provide your mailing address.

Address

Street Address Address Line 2 City State ZIP Code