CCPA Information Request

    Requestor Information

    In order for us to process your request please complete this form and follow all instructions.
    A separate form is required for each user.

    Does your request relate to personal data about yourself? (required)
    I am the consumerI am submitting request for the consumer


    By completing this form I declare that the details on this application are to the best of my knowledge correct. I understand that it may be a criminal offense to obtain (or to attempt to obtain) disclosure of personal data unlawfully.


    After you submit this report you will be issued a "Request Key". Using this request key you will be able to access the Follow-Up functionality of this report.

    Follow-Up will allow you to:

    • Upload/Attach documents to this report

    • Respond to follow-up questions/comments

    • Provide additional information

    Contact Information

    4877 Galaxy Parkway
    Suite I
    Cleveland, OH 44128

    Toll Free: (888) 901-4647
    Local: (216) 514-7480
    Fax: (888) 901-4648

    Contact Us