Privacy Web Form

Nationwide Consumer Privacy Request Form

Depending on your state of residence, you may have certain rights regarding your personal information. You may submit your request using this form. You may read more about Nationwide's privacy practices and your rights in our Consumer Privacy Policy

Once you complete the form, we'll ask you to verify your identity through our online identity verification process by answering a series of questions. If you experience technical errors with or are unwilling to verify your identity through this online process, please contact us at 1-844-541-4300 (12 p.m. - 6 p.m. ET, weekdays) or consumerprivacy@nationwide.com and we will send to you a notary form that must be returned with the notary seal and signatures within 45 days. If we cannot verify your identity, we will not be able to respond to your request.

For better results, provide as much detail as possible. Fields with an asterisk (*) are required.

I am a resident of:

Required

Please choose the option that matches your state of residence.

Making an:

Required

Please choose the type of request that matches the privacy right you are exercising.

First name

Enter your first name.

Middle name

Enter your middle name.

Last name

Enter your last name.

Former last name (if applicable)

Enter your maiden or former last name, if applicable.

Suffix

Select a surname suffix, if applicable.

Date of birth

Enter your date of birth. (MM/DD/YYYY)

Residential address line 1

Enter your Residential Address.

Residential address line 2

Residential city

Enter your Residential City.

Residential state

Select the state you live in from the dropdown menu.

Residential ZIP Code

Enter your Residential ZIP Code using the recommended format.

Nationwide login username

Enter the username you use to log in to your Nationwide account(s).

Phone number

Please enter a 10-digit number with no dashes or other formatting

Email address

Please enter your email address using the recommended format.

Confirm email address