CCPA Right to Delete Personal Information Form

FOR CALIFORNIA RESIDENTS ONLY

RIGHT TO DELETE

The California Consumer Privacy Act (CCPA) allows California residents the right to delete personal information subject to certain limitations in CCPA that we have collected. To exercise this right, complete the form below. We will not use this additional information for anything other than handling your request. To learn more about the CCPA and the rights it gives California residents in relation to their personal information, please visit our Privacy Policy.

First Name:*

Middle Name:

Last Name:*

Email Address:*

I am:*

Date of Birth:

Phone Number:*

Street Address:*

City:*

State:*

Zip Code:*