Authorized Agent Form

To complete this form as an Authorized Agent on behalf of a California resident (who is not yourself), the fields labeled Data Subject refer to the California Resident. The fields labeled Agent refer to you.

You must also complete the Authorized Agent form and attach it to your request. You can upload your completed form by clicking Select a File in the box below and navigating to the file on your computer or device.

To view the full privacy policy scroll down to the bottom of the page and click on the "Privacy Policy" link. To request an alternate format you may email or call (424) 235-0355