California Consumer Protection Act (CCPA) Request Form

Please complete the form below detailing your request. Fields with an asterisk (*) are required fields to submit the form. We will confirm our receipt of your request at the email address provided below and will call you within 10 days to verify your identity before processing your request. We cannot respond to your request or provide you with Personal Information if we cannot verify your identity or authority to make the request and confirm the Personal Information relates to you. We endeavor to respond to a verifiable consumer request within forty-five (45) days of its receipt. If we require more time (up to 90 days), we will inform you of the reason and extension period in writing. There is no fee for normal, reasonable requests; however, we reserve the right to charge a reasonable fee for requests that are manifestly unfounded, excessive or repetitive. Please note that these rights apply only to select California consumers and exclude applicants, employees, and business contacts. Only you, or a person registered with the California Secretary of State that you authorize to act on your behalf, may make a verifiable consumer request related to your Personal Information.

Type of Request(Required)
Describe your relationship with us(Required)
State of Residency(Required)
I declare that the information provided is correct to the best of my knowledge, and that I am entitled to make the request identified above.(Required)