Owl Bridge

CCPA Request Form

How do we know you?

Type of Request

Company Name (if applicable)

First Name

Last Name

Street Address

City

State

Zip/Postal Code

Account or Reference Number (if applicable)

VIN (if known)

Phone Number ((XXX) XXX-XXXX)

Date of Birth (if applicable)

Last 4 of Social Security Number (if applicable)

Description of Information to be Corrected (if applicable)

Note: We will use the personal information that you have provided to us only for the purposes of processing your privacy inquiry. We can not respond to your request if we cannot verify your identity or authority to make the request and confirm the personal information relates to you.

Consumer Enquiry

CCPA Request Form