Consumer Data Request Form

Residents of California may use this form to submit requests to exercise their legal rights for access or deletion of personal information. While not all fields are required, please be advised that we can only search for your information using the details that you provide; if you decline to provide information, our search may be incomplete. If you are completing this request on behalf of another person, please fill in the consumer’s information and add your information in the space provided.

Nature of Request (i.e., what would you like us to do?): *

First Name: *

Last Name: *

Email Address: *

Address: *

City: *

State: *

Zip Code: *

Mobile Phone Number:

Other Identifying Details We Should Search (IP Addresses, Device IDs, etc):

Please describe the nature of Consumers relationship with Company: *

Are you completing this request on behalf of another individual?:

Yes No

For the protection of our customers, it may be necessary for us to request additional details, including a government-issued photo ID, to confirm your identity before we act on your request. We will contact you by email if this is necessary. We will not use personal information submitted for the purpose of a Consumer Data Request for any purpose other than to effectuate your request.