By using this form, you may elect to exercise your privacy rights as a California resident. You may also submit a request to exercise these rights by calling us at 1-855-275-5787.
Instructions: Please complete the required fields below. Information collected on this form will be used and retained only to process your request.
We will comply with your request to know your personal information unless the personal information is outside the scope of California’s privacy laws, is otherwise exempt from disclosure, or we cannot confirm your identity. Note that California law prohibits us from disclosing certain sensitive types of information including financial account numbers, an account password, or security questions and answers.
Please confirm your identity.
We will contact you by email or phone to confirm your identity. If you do not have a web-access account with us, we will contact you by email or phone to collect the necessary information.
If we are unable to verify your identity as part of your request, we may be prohibited from fulfilling your request.
Delivery of Specific Pieces of Information
Submit a request on behalf of some else
If you are requesting personal information on behalf of someone else, We will contact you and you’ll be expected to provide an authorization letter. We may require the person to verify their identity with us directly and to verify that you have been authorized to submit a request on their behalf. If we verify that you are authorized to know the requested personal information, we will contact you to collect additional information.
Declaration under penalty of perjury
By submitting this form, you agree, on penalty of perjury or other criminal offense under applicable law, that either you are the individual about whom this request for personal information relates, or that you are authorized by that individual to make this request on their behalf.
