CCPA Consumer Request Form

The California Consumer Privacy Act of 2018 (CCPA) provides consumers who are California residents with specific rights regarding their Personal Information. California residents also have the right to ask us to delete any Personal Information that we have collected about them, subject to certain limitations as set forth under CCPA. AMI COLÉ will use the information in this request form and respond to your request in accordance with the CCPA. AMI COLÉ will maintain a record of your request pursuant to Civil Code section 1798.105(d).

First name*

Last name*

Street Address*

Apartment, Suite, Floor, etc*

City*

Zip code*

Phone number*

Email address*

I am a California resident

I hereby authorize a request for my personal information and/or a request to delete my personal information pursuant to the CCPA.

I hereby request the following from AMI COLÉ (check all that apply)

Inform me about what categories of personal information AMI COLÉ has collected about me

A copy of my personal information

Deletion of my personal information

By submitting this form I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

CCPA Consumer Request Form

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