Request for Information - California Residents

California law provides consumers with the right to request access or deletion of their personal information. If you are a California resident and wish to exercise a legal right pursuant to the California Consumer Privacy Act, please fill out the form below to continue with your request. If you are an authorized agent of a California resident and wish to exercise a legal right pursuant to the California Consumer Privacy Act on behalf of that person, please fill out the form below (including Authorized Agent Contact Information) to continue with your request.

California Resident Information Request Form

Please confirm you are a resident of California *

I represent and warrant that I am a California resident and I wish to exercise a legal right pursuant to the California Consumer Privacy Act on behalf of myself. I further declare under penalty of perjury that I am the consumer whose personal information is the subject of the request.
I represent and warrant that I am an authorized representative of a California resident and I wish to exercise a legal right pursuant to the California Consumer Privacy Act on behalf of that person. I further declare under penalty of perjury that such person is the consumer whose personal information is the subject of the request.
I am not a California resident or an authorized representative of a California resident.

First Name *

Last Name *

Email Address*

Phone Number *

Resident Address Information (required)

Address *

Address 2

City *

Zip *

Authorized Agent Contact Information

First Name

Last Name

Email Address

Phone Number

Please tell us more about your request *

I WANT TO ACCESS THE CATEGORIES OF PERSONAL INFORMATION COLLECTED OR SHARED ABOUT THE CALIFORNIA RESIDENT NAMED ABOVE.
I WANT TO ACCESS THE SPECIFIC PIECES OF PERSONAL INFORMATION COLLECTED OR SHARED ABOUT THE CALIFORNIA RESIDENT NAMED ABOVE.
I WANT TO DELETE THE PERSONAL INFORMATION COLLECTED OR SHARED ABOUT THE CALIFORNIA RESIDENT NAMED ABOVE.
I WANT TO OPT OUT OF THE SALE OF PERSONAL INFORMATION BELONGING TO THE CALIFORNIA RESIDENT NAMED ABOVE.

Request for Information - California Residents

California Resident Information Request Form

Please confirm you are a resident of California *

Resident Address Information (required)

Authorized Agent Contact Information

Please tell us more about your request *

Company Information

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