CCPA Request The California Consumer Privacy Act of 2018 (“CCPA”) provides California residents certain rights with respect to their personal information. To exercise such rights, please provide the appropriate information below:VerificationIn order to process your CCPA request, we need to verify you. Please provide the following information, as you believe it would appear in our records: Name:First*Last*Email or Phone:Email* Phone*Zip Code*Please select the applicable box:I certify that I am a California resident submitting this request for my own information only.* I certify that I am a California resident submitting this request for my own information only. I certify that I am an authorized agent submitting this request on behalf of a California resident. I may be required to submit proof that I have been duly authorized to act on their behalf.* I certify that I am an authorized agent submitting this request on behalf of a California resident. I may be required to submit proof that I have been duly authorized to act on their behalf. I certify that I am a California resident submitting this request for information on my household. I may be required to submit information to verify all persons in my household.* I certify that I am a California resident submitting this request for information on my household. I may be required to submit information to verify all persons in my household. Information Request OptionsPlease select the applicable box(es) and provide any corresponding information below:Disclosure of categories of personal information collected about me Disclosure of categories of personal information collected about me Disclosure of categories of sources from which my personal information was collected Disclosure of categories of sources from which my personal information was collected Disclosure of business purpose for collecting my personal information Disclosure of business purpose for collecting my personal information Specify any category of personal information you would like addressedDisclosure of categories of third parties with whom my personal information was shared Disclosure of categories of third parties with whom my personal information was shared Disclosure of categories of my personal information shared with third parties Disclosure of categories of my personal information shared with third parties Disclosure of specific pieces of personal information collected about me Disclosure of specific pieces of personal information collected about me Specify any categories for which you’d like us to provide pieces of your personal informationDeletion of personal information collected about me Deletion of personal information collected about me Specify any category of personal information you would like addressedPlease provide any additional details, if necessaryIf not provided above for verification, please provide an email address to contact you about your request CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.
