Dear sir/mam,
I am writing to request a correction to the information I provided in a recent Google form submission. Unfortunately, I made a mistake while filling out the form and I would like to rectify it.
I apologize for any inconvenience this may have caused and I appreciate your understanding. Please let me know if you need any further information or if there is anything else I can do to assist in correcting this mistake.
Thank you for your time and attention to this matter