California Consumer Privacy Act Requests Web Form

As a California Resident, you may complete this form to submit a request under the California Consumer Privacy Act (CCPA). If you are unable to complete this form for any reason or have questions, please contact us at, 1-888-474-9519.
This page describes the information we need, the information types you may request from us, and how we will verify your identity in order to respond or process your request.
Your Rights as a California Resident
As a California resident, you have the following rights over personal information subject to the CCPA:
  • To know:
    • The categories of personal information we collected about you
    • The Categories of sources of your personal information we collected
    • Our business or commercial purpose for collecting your personal information
    • The categories of third parties to whom we share your personal information
    • The specific pieces of personal information we have collected about you
    • The categories of personal information we have disclosed about you for a business purpose
    • The categories of persons to whom we have disclosed personal information for a business purpose
  • To request deletion of your personal information (excluding legal and business exceptions)
  • To request correction of your personal information
  • To limit use and disclosure of sensitive personal information
  • To opt out of the sale or sharing of personal information. Please note that we do not sell your personal information.
Verification Process
In order to verify your identity with your request, we may require the following information from you:
  • Request to Know Categories Report – name, email address, and home address
  • Request to Know Specific Pieces Report – name, email address, home address, last 4 of SSN, date of birth, and a verification under the penalty of perjury
  • Request to Delete – name, email address, home address, last 4 of SSN, date of birth, and a verification under the penalty of perjury
  • Request to Correct - name, email address, home address, last 4 of SSN, date of birth, and a verification under the penalty of perjury

Please indicate which request(s) you would like to make: