California Consumer Privacy ACT (CCPA): Request Form

CALIFORNIA CONSUMER PRIVACY ACT (CCPA): REQUEST FORM

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Name*

First Last

Email*

Please Enter Your California Address

Address*

Address Line 2

City*

California

Zip Code*

Please select your request type(s):*

Delete my information

Do not sell my information

Data information request

Your IP Address is:

Consent*

By submitting this form, I confirm that: The above information is true and correct, and I am the person, or an authorized agent of the individual identified above.

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