Home Forms California Consumer Privacy Act  Disclosure Request

California Consumer Privacy Act  Disclosure Request

Personal Information Request Form
We take your privacy and the protection of your personal information seriously. California residents who wish to exercise their rights under the California Consumer Privacy Act (CCPA) can complete and submit this form to request a copy of your personal information, certain information about how we process your personal information, and/or deletion of your personal information in our systems.







If you are an agent submitting a request on behalf of someone else, you must submit written authorization from the data subject demonstrating that you are authorized to submit the request.


Note for Deletion Request:
Your request for deletion of personal information has been received. We will attempt to verify your identity based on the information provided in the request form. If we are unable to verify your identity, we will notify you via email that we will be unable to fulfill your request under applicable law.

If we are able to verify your identity, we will delete your personal information within a maximum of 45 days by erasing on existing systems the personal information requested to be deleted, and will send you a written confirmation via email. We will maintain a record of your request as allowed by California Civil Code section 1798.105(d).

Note for Access Request/Information Request:
Your request for access to or information about how we process your personal information has been received. We will attempt to verify your identity based on the information you provided in the request form. If we are unable to verify your identity, we will notify you via email that we will be unable to fulfill your request under applicable law.

If we are able to verify your identity, you will receive a response disclosing the information you have requested via email within a maximum of 45 days.

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