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CCPA Online Request Form

The California Consumer Privacy Act (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. Please complete the form to submit a request.

Your Name

Confirm Email

Street Address

Apartment, Suite, Floor, etc.

Country

State

City

ZIP Code

Phone Number

I am a resident of California

I hereby request the following from MZ Wallace (Check all that apply)

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 Online Request Form

Thank You