Privacy Request Form

Privacy Request Form for CPRA rights.

Note: This form is only for California residents exercising their CPRA rights. If you are not a California resident, please contact us using the appropriate channels for privacy-related inquiries.

Contact Information

Full Name: [Your Full Name]

Email Address: [Your Email Address]

Phone Number: [Your Phone Number]

Verification Information

Please provide information that will help us verify your identity. This information is necessary to protect your privacy and ensure that we only disclose or delete personal information about the individual who is the subject of the request.

  1. Account Information (if applicable):
    • Username: [Your Username]
    • Account Number: [Your Account Number]
  2. Any other relevant details to help us identify your personal information in our records.

Select Your Request

Please select the appropriate request from the options below:

  1. Request to Know: I am requesting information about the personal information that has collected, used, disclosed, or sold about me.
  2. Request to Delete: I am requesting the deletion of the personal information that has collected from me.
  3. Request to Opt-Out: I am a California resident, and I request to opt-out of the sale of my personal information.

Authorized Agent (if applicable)

If you are submitting this request on behalf of someone else as their authorized agent, please provide the following:

  • Your Full Name: [Authorized Agent’s Full Name]
  • Your Email Address: [Authorized Agent’s Email Address]
  • Your Phone Number: [Authorized Agent’s Phone Number]

Please upload a copy of the written permission from the California resident allowing you to act as their authorized agent.

Additional Information (optional)

If you have any additional information or comments that you believe may assist us in processing your request, please provide them here:

[Additional Information Text Box]

Verification Statement

By submitting this form, I declare under penalty of perjury that I am a California resident or an authorized agent acting on behalf of a California resident, and the information provided in this form is accurate and true to the best of my knowledge.

Submit Your Request

Please submit this completed form and any relevant documentation by [Submit Button].