By submitting this request, I am confirming the following:
1. Accuracy: that the information I have provided is true and accurate;
2. Privacy: that I understand the information I have provided will be used to verify my identity, to process my request, and will be handled by Teknor Apex in accordance with our privacy statement;
3. Contact: that Teknor Apex has the right to contact me to verify my identity and to process this request.