CCPA Consumer Request Concerning Personal Information
Consumers who are requesting to exercise their rights under the California Consumer Privacy Act (CCPA) are required to submit this form. Proof of identity may be required to ensure that the request is valid. It is your responsibility to send any sensitive data through secure methods.
Once validated, each request should receive a response within 45 business days. However, you will be informed if more time is needed as certain limitations may affect our ability to adhere to your request within this timeframe.
Complete each of the required fields below and enter submit. If you prefer, you may also print out this page to fill out by hand. Handwritten versions may be completed and submitted through document scanning to firstname.lastname@example.org or through standard U.S. Mail. We will communicate back with you using the method you specify below. Where applicable, email or U.S. Mail may be used for responses. All information collected through this verification process will only be used for verification purposes and then destroyed. If you have any questions, you can email us at email@example.com or by calling 800-429-7473.
Corrections to your data
After filling out this form and recieveing your data, you can make any necessary corrections by replying to firstname.lastname@example.org.