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M3GR California Consumer Request Form For Exercise of Rights Under California Consumer Privacy Act
Your request has been sent.
Please complete the information below. When you have completed the required information, submit the form by clicking "submit" at the bottom. After receiving this form, we will be in touch to verify your identity and respond.
* Field Required
1. Complete the following information of the person whose information is the subject of this request:
* Last Name, First Name, Middle Name:
Member User ID (if known):
* Phone Number: [Format: (951) 345-4321]
* E-mail Address:
Alternate User ID(s) or E-mail Address(es):
* City and State of Residency:
* 2. Request Type [check all that apply]:
What Personal Information of mine is collected and/or processed?
I request access to specific pieces of my Personal Information (please describe in text box below)
I request access to these categories of my Personal Information (please describe in text box below)
Delete all of my Personal Information
Delete specific pieces of my Personal Information (describe in text box below)
Please select a request type.
3. Additional Details. Please help us understand your request by providing additional details below.
If Submitted On Behalf of A Consumer: provide via email (
) the Authorized Agent's name and written permission or a Power of Attorney ("POA") from the consumer this request concerns (a free copy of California's Uniform Statutory POA is found here: