California Consumer Privacy Act Request Form

Last updated: February 18, 2022


If you are a resident of California and would like to submit a consumer request under the California Consumer Privacy Act (CCPA) according to our California Consumer Privacy Statement, please fill out and submit the Form herein below the instructions.

If we require additional information from you in order to verify or process your request, or if we need clarification about the nature of your request, we will contact you at the email you indicated in the Form.


1. Please, fill out the following Electronic Request Form or print and fill out the PDF Request Form by hand or fill it in directly electronically.

2. Send a paper copy of the PDF Form duly completed by mail at 4593, Ish Drive, suite 320, Simi Valley CA 93036 or an electronic copy, a scan or a photo by email at

3. Upon reception of the Form, we will communicate with you to confirm your email address and your request.

4. Your request will be processes, within thirty (30) days ONLY upon your email address and request have been verified.

Electronic California Consumer Privacy Act Request Form

NOTE : As we do not sell any personal information,  a “request to do not sell my personal information” is not applicable.

*IMPORTANT NOTE : If you are an authorized consumer agent, please complete the following fields.

PDF California Consumer Privacy Act Request Form

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