HOW TO USE THIS FORM TO SUBMIT A REQUEST
To submit a request, fill in the fields below as thoroughly as possible. Be sure to indicate which type of request you are making by using the first drop down field in the form. Options are: Request to Know Categories of Personal Information, Request to Know Specific Personal Information, or Request to Delete Personal Information. For Requests to Know and Requests to Delete, you will receive our confirmation or receipt no later than 10 days from when we receive your request.
Click the Submit button at the end of the form when you have filled out the form as completely as possible.
By clicking the Submit button you are affirming, under penalty of perjury, that you are the individual named in the request, or that you are the Authorized Agent and have submitted a CCPA Authorized Agent form signed by the data subject and notarized. Authorized Agent forms may be submitted to email@example.com.