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CCPA Third Party Request Form

If you are a California resident and want to authorize someone else to submit a request for information and/or a request to delete on your behalf pursuant to the California Consumer Privacy Act of 2018 (CCPA), please complete this form and provide it to the person you are authorizing to submit a request on your behalf. They will be asked to provide the form when they submit your request.  AMI COLÉ will use the information in this request form and respond to a request made on your behalf in accordance with the CCPA.  AMI COLÉ will maintain a record of your request pursuant to Civil Code section 1798.105(d).






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

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