CCPA Opt-Out Request Form

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Under the California Consumer Privacy Act (CCPA), you have the right to opt out of the sale or sharing of your personal information. Please fill out this form to submit your opt-out request. We will process your request within the legally required timeframe.

Full Name *

Email address *

Phone number *

Request type *

Opt-out of the sale of personal information

Opt-out of the sharing of personal information for targeted advertising

Both

State of Residence *

Do you authorize an agent to submit this request on your behalf? *

Yes

If applicable, provide the agent’s email

Additional Comments

Consent Checkbox *

I confirm that the information provided is accurate, and I am a California resident or authorized agent submitting this request on behalf of a California resident.

Required

Submit

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