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CCPA

California Consumer Privacy Act (CCPA) Form

California Consumer Privacy Act (CCPA) Verifiable Consumer Request Form

For more details, please see the Privacy Notice and Disclosure for California Residents here.

All fields are mandatory. Please fill in sufficient information, so that your request can be processed successfully. 

I. Requestor Category (select one)

Category of Request

II. Request Type (check all that apply)

Select Request Type
Request to know categories of personal information collected.
Request to know specific pieces of personal information. Signed declaration required

(Signed Declaration is required for this option)

Request deletion of personal information. Signed declaration required.

(Signed Declaration is required for this option)

Request correction of personal information. Signed declaration required.

(Signed Declaration is required for this option)

Download Declaration Form here

III. Please provide the following information to help us process your request:

Information required for your request

IV. Response Type

Select Preferred Response Type
Email

Thank you! Please wait while your request is being submitted

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