California Privacy Request Form
The information you provide in this form will be used for the purpose of responding to your request, including verifying identity, locating personal information related to your request, and keeping records of your request. For certain requests, we may ask for additional information to verify the identity of the consumer who is the subject of the request, verify the identity of an authorized agent or to obtain additional information to respond to the request.
Please note that due to the different requirements of the applicable laws, our response times may vary depending on the specific type(s) of information sought. We will respond to most verified consumer requests under the CCPA within forty-five (45) days of receipt. If we require more time, we will inform you of the reason for the extension.
You may submit a request by using this form. You may also submit a request by:
- Emailing us at firstname.lastname@example.org (please note in subject line “Privacy - CCPA Consumer Request)
- Calling us at 877-792-9455
- Sending a request to:
CCPA Consumer Request
4020 S. 26th Street
Philadelphia, PA 19112
Please fill out the following information to submit a request: