This form is to be used to submit requests pursuant to the California Consumer Privacy Act (CCPA). If you are a California resident you may make a request to exercise your CCPA rights by completing this form.
THIRD PARTY AGENT REQUESTS. This form is intended to be used by individuals to make requests directly on their own behalf. You may authorize a third party to submit requests subject to the CCPA on your behalf, however, in order to exercise this right, you must first please provide a written letter, signed by you, stating clearly who you are authorizing to act on your behalf and what authority you are granting them. A third party agent may submit the written authorization and request to: email@example.com.