CCPA

CALIFORNIA CONSUMER PRIVACY ACT REQUEST

*First Name:

*Last Name:

*Your Email Address:

*Your Telephone Number:

Consumer

Authorized Agent

Parent/Legal Guardian making a request on behalf of a minor child

Know Personal Information Collected or Disclosed

Delete Personal Information

Specific Pieces of Personal Information

Both Categories and Specific Pieces of Personal Information

Consumer’s First Name:

Consumer’s Last Name:

Consumer’s Street Address:

Consumer’s City of Residence:

Consumer’s State of Residence:

Consumer’s Zip Code

Consumer’s Email Address:

Year of Vehicle (Enter “N/A” if not applicable):

Make and Model of Vehicle (Enter “N/A” if not applicable):