Home > California Consumer Privacy Act Request California Consumer Privacy Act Request Name(Required) First Middle Last I am or have been in the last 12 months a California resident:(Required) Yes No Please note you must be a California resident to request information based on the California Consumer Privacy Act.Email(Required) Phone(Required)Please describe in what capacity or context you have interacted with us to date in which you may have provided personal information to us:(Required) Employee Job Applicant Independent Contractor or Consultant Website User App User Individual Customer (non-entity) Service Provider, Vendor or Supplier Other "Other," please specify(Required) Type of Request(Required) Request to Know Access Request Request to Correct Request to Limit Use and Disclosure of Sensitive Personal Information Request for Deletion Request to Opt-Out of Sale/Sharing of Personal Information Request to Withdraw From Financial Incentive Program Request to Know(Required) Categories of personal information collected from or about me since 1/1/2022. Categories of sources from which the personal information was collected. Business purpose for which the personal information was used. Categories of third parties to which the personal information was disclosed since 1/1/2022. Please provide me with the specific pieces of personal information collected from or about me since 1/1/2022.(Required) Yes No Please correct personal information you have collected from me.(Required) Yes No Please enter a short description of the personal information you believe is incorrect, using the box below.(Required)Please enter the correct personal information in box below.(Required)Are you sure you want us to correct the personal information that you have identified?(Required) Yes No Please limit your use and/or disclosure of my sensitive personal information to only those purposes expressly prescribed by the California Privacy Rights Act.(Required) Yes No Please delete all personal information that you have collected from me.(Required) Yes No Are you sure you want us to permanently delete all your personal information that we have collected from you?(Required) Yes No Request to Opt-Out of Sale/Sharing of Personal Information(Required) I do not want my personal information to be sold. Please cease and refrain from selling my personal information. I do not want my personal information to be shared with a third party for cross-context behavioral advertising purposes. Please cease and refrain from sharing my personal information for such purposes. I wish to withdraw from the Company’s financial incentive or loyalty rewards program. Please delete my account. I understand that by withdrawing from the program and having my account deleted, I will not be receiving any of the financial incentives, rewards, benefits or discounts that I may have previously earned or accrued as a member of this program.(Required) Yes No Authorized Agent Verification Yes No Agent's Name(Required) First Last This agent has been authorized in writing to submit this request on my behalf:(Required) Yes No HomePrivacy Policy Site Map
