If you are a California resident and would like to submit a Consumer Request under the California Consumer Privacy Act (CCPA), please fill out and submit the below web form.
Are you a California resident? By clicking yes below, you certify and declare under the penalty of perjury that you are a resident of California:
1. California Residency * 2. Relationship to Consumer *
If you are a parent/guardian submitting a request related to your minor children, please see sections 15-16 for additional information you must provide.
If you are an authorized agent, please see sections 15-16 for additional information you must provide.
If you have multiple requests, please submit a separate form for each request.
4. Consumer's First Name * 5. Consumer's Middle Initial 6. Consumer's Last Name * 7. Consumer's Email Address * 8. Consumer's Phone Number * 9. Consumer's Country * Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Côte d’Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor (Timor-Leste) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Fiji Finland France Gabon The Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria North Macedonia Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Sudan, South Suriname Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe 10. Consumer's State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 11. Consumer's Postal Address * 12. Consumer's City * 13. Consumer's Zip code * 14. Preferred Method of Response Delivery *
If you are a parent/guardian submitting a CCPA rights request related to your minor child, please email a written notarized statement under penalty of perjury (and fraud) that you are the guardian of the minor whose CCPA rights you are seeking to exercise. If you do NOT provide the signed notarized statement, we cannot honor any request you submit on behalf of a minor child. After submitting your request through the webform, please email your notarized statement as an attached PDF to
[email protected] The subject line of the email should read as "Parent/Guardian - Notarized Statement - [Request ID]". The Request ID must be included and will be displayed after this web form is submitted.
16. Authorized Agents
If you are serving as an authorized agent for a California consumer, please email a written notarized authorization form from the consumer that you represent, or a Power of Attorney document, authorizing you to serve as the consumer's agent for the purposes of exercising the consumer's rights under the CCPA. If you do NOT provide the signed authorization, we cannot honor any requests you submit on behalf of a consumer. After submitting your request through the webform, please email your notarized statement attached as a PDF to
[email protected] The subject line of the email should read as "Authorized Agent - Notarized Authorization - [Request ID]". The Request ID must be included and will be displayed after this web form is submitted.