Category of Personal Information | Is information collected by us? | Is information transferred for business purposes? |
Audio, electronic, visual, thermal, olfactory, or similar information | ☐ | ☐ |
Bank account number | ☐ | ☐ |
Biometric information | ☐ | ☐ |
Characteristics of protected classifications (e.g., age, sex, race, ethnicity, physical or mental handicap, etc.) | ☐ | ☐ |
Commercial information (e.g., products or services purchased, or other purchasing or consuming histories or tendencies) | ||
Credit card number | ||
Debit card number | ||
Driver’s License Number / State ID | ☐ | ☐ |
Education | ☐ | ☐ |
Electronic network activity (e.g., browsing history) | ||
Email address | ||
Employment | ||
Employment history | ☐ | ☐ |
Geolocation data | ||
Health insurance information | ☐ | ☐ |
Identifiers (e.g., name or alias) | ||
Insurance Policy Number | ☐ | ☐ |
Medical information (not covered by HIPAA) | ☐ | ☐ |
Online identifier (e.g. IP address) | ||
Other financial information | ☐ | ☐ |
Passport Number | ☐ | ☐ |
Physical Characteristics | ☐ | ☐ |
Postal address | ||
Signature | ||
Social Security Number | ☐ | ☐ |
Telephone Number | ||
Transaction information |
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