CCPA Request - (OmegaXL.com - English)

Is the person whose personal information is the subject of this request (the “consumer”) a California resident?*

Yes

Please check the box to continue.

Website

Assignee ID

brand_id

Information about the person submitting this request:

Name*

First Name

Last Name

Email*

Confirm Email *

Phone*

What type of request do you wish to make?*

KNOW — Request to know the categories of personal information we have collected about the consumer in the preceding 12 months, the categories of sources for such personal information, our business purposes for collecting such personal information, and the categories of third parties with whom we have shared such personal information. ACCESS — Request to receive access to a copy of the specific pieces of personal information we have collected about the consumer in the preceding 12 months. DELETE — Request to delete all personal information we have collected about the consumer.

Please select one. If you wish to make more than one type of request, please submit a separate request form for each request.

Please select the applicable statement.*

I am the above consumer. I am an authorized agent of the consumer.