Name I am or have been in the last 12 months a California resident: Yes No You must be a California resident to request information based on the California Consumer Privacy Act. If the requestor clicks “No”, they should not be able to submit a request or any further information (unless where the consumer privacy laws of other states apply to require extending any of these consumer rights to residents of other states besides California) Email: Phone Number: Address: Please describe in what capacity or context you have interacted with us to date in which you may have provided personal information to us. Check all boxes that apply. Employee Job Applican Independent Contractor or Consultant Website User App User Individual Customer (non-entity) Service Provider, Vendor or Supplier Other: Please Specify Below "Other" Details Below: Type of Request Request to Know • Categories of personal information collected from or about me since 1/1/2022 • Categories of sources from which the personal information was collected • Business purpose for which the personal information was used • Categories of third parties to which the personal information was disclosed since 1/1/2022 Access Request • Please provide me with the specific pieces of personal information collected from or about me since 1/1/2022 Request to Correct • Please correct personal information you have collected from me. Request to Limit Use and Disclosure of Sensitive Personal Information • Please limit your use and/or disclosure of my sensitive personal information to only those purposes expressly prescribed by the California Privacy Rights Act Request for Deletion • Please delete all personal information that you have collected from me Request Choice: Request to Know Access Request Request to Correct *Must Provide Details on Next Page* Request to Limit Use and Disclosure of Sensitive Personal Information *Must Provide Details on Next Page* Request for Deletion *Must Provide Details on Next Page* Request to Correct - Skip this Step if this is not your Request Personal Information you believe is incorrect: Correct Personal Information: Are you sure you want us to correct the personal information that you have identified? Yes No Request to Limit Use and Disclosure of Sensitive Personal InformationPlease limit your use and/or disclosure of my sensitive personal information to only those purposes expressly prescribed by the California Privacy Rights Act Skip this Step if this is not your Request Request to Limit Use and Disclosure of Sensitive Personal InformationPlease limit your use and/or disclosure of my sensitive personal information to only those purposes expressly prescribed by the California Privacy Rights Act Yes No Request for Deletion Are you sure you want us to permanently delete all your personal information that we have collected from you? Yes No This request has been submitted through an agent on my behalf: Yes No N/A Agent’s Name: This agent has been authorized in writing to submit this request on my behalf: Yes No N/A Submit 45451