Confidential · Client Intake

Identity Data Removal

Secure Intake

Provide the identifying information below so MERIDIA can locate your exposed identity data across private data brokers, public-record aggregators, people-search sites and other online sources — and work to reduce that exposure. The more complete and accurate the detail, the more thorough the coverage.

How your data is handled. This form is transmitted over an encrypted (HTTPS) connection and submissions are restricted to authorized MERIDIA personnel. We collect only what is required to file opt-out and removal requests on your behalf, retain it only as long as needed to complete and maintain those requests, and never sell or share it. Identity documents are optional — provide them only if you want us to handle the brokers that require verification, and redact them first. Details you give us about a spouse, partner or relative are used solely to identify and remove listings that already name them alongside you.

Don't fill this out:

Identity

Full legal name *

Other names used (maiden, aliases, former names — optional)

Date of birth *

Required — distinguishes you from others with the same name; many brokers require it to verify a request.

Email Addresses

Email 1 *

Email 2 (optional)

Email 3 (optional)

Additional emails (optional — any beyond the three above)

Phone Numbers

Phone 1 *

Phone 2 (optional)

Addresses

Current address *

Previous addresses (optional — last ~10 years helps most)

Brokers index historical addresses heavily — listing past ones improves exposure coverage.

Additional Context (optional)

Employer / organization (optional)

Spouse / partner name (optional)

Spouse / partner date of birth (optional)

Name and date of birth. Brokers index spouses alongside you and frequently confuse same-name individuals; a date of birth is what separates your household’s record from someone else’s. Used only to identify and remove listings — we never open a separate file on your spouse without their own signed authorization.

Other relatives / household members (optional)

People-search sites cross-link relatives; providing them helps us request fuller removals. Dates of birth are not needed here — names alone are enough.

Anything else we should know

Identity Verification (optional)

A minority of brokers will not process an opt-out without proof of identity. Uploading a document here lets us clear those without coming back to you. Everything in this section is optional — skip it and we will still work every broker that does not require verification, then tell you which ones remain.

Document type

ID — front (optional)

ID — back (optional — skip for passports)

Second document (optional)

Some brokers ask for two forms of ID, or for a utility bill, bank statement or lease showing your name at the address being removed.

Spouse / partner ID (optional)

Only if your spouse or partner has authorized removal of a joint listing and is aware this is being submitted. We will not act on their individual records without their own signed authorization.

Before you upload: black out the photograph, the document number and any licence class or endorsement codes. Brokers verify a name, address and date of birth — nothing else on the document is needed, and a redacted copy is accepted almost everywhere. Images or PDF, up to 8 MB per file.

Authorization

I authorize MERIDIA to act as my agent to submit opt-out and removal requests to private data brokers, public-record aggregators, people-search sites and other online sources on my behalf, using the information provided here. *

I consent to MERIDIA storing and processing this information for the purpose of identity data exposure reduction, in line with the data-handling notice above. *

Transmitted over an encrypted connection. You'll see a confirmation after submitting.