CCPA Data Request Form

Consumer Privacy Act Data Request Form

Request to not sell or share your personal information

Select your State*

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Please refer to our Privacy Policy for additional information.

What can we do for you?*

Send me my data (Last 12 months)Send me a copy of my personal informationRectify my dataDelete my personal information

Request to know any of the following:*

Specific pieces of personal information that BYLT Basics has about meCategories of personal information BYLT Basics has collected about meCategories of sources from which BYLT Basics collects my personal informationCategories of personal information that BYLT Basics has disclosed about me for a business purposeCategories of third parties to whom my personal information was disclosed for a business purposeThe business or commercial purpose for collecting my personal information

Customer First Name*

Customer Last Name*

Customer Email Address*

Requester*

Agent First Name*

Agent Last Name*

Agent Email Address*

(Please note that we will not be able to process this request if we cannot verify your authorization as an agent to make this request on behalf of the consumer.)

I certify that the information in this form is true and correct. I understand that it is necessary for BYLT Basics to verify my identity and/or authorization to make this request on behalf of the individual for whom BYLT Basics has collected personal information about. I certify under penalty of perjury that I, the individual whose personal information is the subject of this request, am a California resident. Select to agree.*