California Consumer Privacy Act Request Form Question Title * 1. First Name: Question Title * 2. Last Name: Question Title * 3. Email: Question Title * 4. Phone: Question Title * 5. Are you making this request on your behalf? Yes No Question Title * 6. If No (previous question) The information of the person on whose behalf you are making this request: Name: Email: Phone Number: Question Title * 7. What are you requesting? To know the categories of personal information collected, processed and/or shared within the previous 12 months To access the specific pieces of personal information we have collected, processed and/or shared within the previous 12 months To delete my personal information Done