California Residents: CCPA Request

First Name

Last Name

Email Address Used on Our Website

State of Residence

What is the Nature of Your Request (Please Choose One) What is the Nature of Your Request (Please Choose One) Access to Personal Information Deletion of Personal Information Opt-Out of Sale of Personal Information

For access requests only: under penalty of perjury, by selecting a radio button and submitting the form, I hereby certify in writing that I am the individual to whom this personal information request relates (or I am such individual’s authorized agent), and that my receipt of this personal information does not violate any applicable law or any privacy or publicity rights of any individual. This attestation is provided in accordance with Section 999.325(c) of the regulations promulgated by the Attorney General under the authority of the California Consumer Privacy Act of 2018. For access requests only: under penalty of perjury, by selecting a radio button and submitting the form, I hereby certify in writing that I am the individual to whom this personal information request relates (or I am such individual’s authorized agent), and that my receipt of this personal information does not violate any applicable law or any privacy or publicity rights of any individual. This attestation is provided in accordance with Section 999.325(c) of the regulations promulgated by the Attorney General under the authority of the California Consumer Privacy Act of 2018. I certify that I am a California Resident, and that all information provided above is accurate.