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CCPA Consumer Request Form

The California Consumer Privacy Act, as amended by the California Privacy Rights Act of 2020 ("CCPA"), allows California residents to make certain requests to know, request to delete, and requests to correct related to their personal information.

Consumer Information

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Email Address

I am authorized to submit this request on behalf of another individual who is a California resident.

Authorized Agent Information

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Select one or more of the following requests:

Know what categories of personal information we collected about the Consumer, the categories of sources from which the personal information was collected, the business or commercial purpose for collecting, the personal information, the categories of personal information we disclosed for a business purpose, and for each category identified, the categories of third parties to whom we disclosed that particular category of personal information.

Access specific pieces of personal information that we collected and maintain about the Consumer.

Correct inaccurate personal information we maintain about the Consumer. (Please access your account online or contact Customer Service at 1-800-987-5521 to update any contact information on your account.)

Delete all personal information we have collected about the Consumer.

Yes, I confirm that I want my data deleted.

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