I affirm and certify that by submitting this form all the information and answers to questions herein are complete, true and correct to the best of my knowledge and belief; that I am a California resident; and that I am the individual whose data I seek to have you delete or an authorized agent acting on their behalf. I understand that any misrepresentation, falsification, or omission of any facts called for in the form may render it void.
CCPA Request Type Named Herein:
“Request to know” the categories and/or specific pieces of of personal information collected, shared, and used, sources obtained from, business purposes, sales and/or disclosures of personal information“Request to delete” personal information“Request to opt-out” any sales of personal information to third-parties
I attest under penalty of perjury that I am California resident described herein, orRepresent and warrant that I am authorized representative of the California resident described herein, authorized to exercise such California resident’s legal right pursuant the CCPA