CALIFORNIA CONSUMER PRIVACY ACT (“CCPA”)
DATA REQUEST FORM

California residents have the right to request that the Company disclose or take certain actions in relation to personal information collected by the Company during the past twelve (12) months. If you are a California resident and would like to request that the Company disclose or take a specific action in relation to the collected data, please complete and submit the following form:

REQUEST TYPE [Check the Applicable Box]

Form is incomplete; please complete missing fields in red.

* Required

THIS REQUEST IS RESERVED FOR CALIFORNIA RESIDENTS ONLY. BEFORE PROCEEDING, PLEASE ATTEST TO YOUR CALIFORNIA RESIDENCY.

This information will be used solely to process your CCPA data request and for no other purpose. The Company will maintain a record of your request pursuant to California Civil Code Section 1798.105(d).

If you are submitting a request on behalf of a California consumer, you must attach written proof that you have been authorized by the consumer to operate on his/her behalf when you reply to the verification e-mail.

You're all set! Keep an eye out for your first interest list email.

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