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I am an authorized agent acting on behalf of a California, Colorado, or Connecticut consumer.

If acting on behalf of the consumer as an authorized agent, please ensure the form above contains all correct information for the consumer you are requesting for, not your own. Please enter your information in the form below.

First Name

Last Name

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Example: 9234567890

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Please Select the Reason for Your Request:

Know/Access Request

Deletion Request

Correction Request

Sharing Opt-Out Request

Please Select the Reason for Your Request:

Access/Portability Request

Deletion Request

Correction Request

Targeted Advertising Opt-Out Request

Appeal Request

What information would you like to correct?

8 Digit Case Number

I declare that I am the person identified as the consumer above or I am acting with the authority of the consumer to submit this request on their behalf and that all information entered above is true and correct.

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