Name
I am or have been in the last 12 months a California resident

Please note you must be a California resident to request information based on the California Consumer Privacy Act.

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
please specify
Would you like to access Employee Workplace Injury or Illness Records?
  • 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.

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. 

Are you sure you want us to correct the personal information that you have identified?

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. 
Are you sure you want us to permanently delete all your personal information that we have collected from you?
  • I do not want my personal information to be sold. Please cease and refrain from selling my personal information.
  • I do not want my personal information to be shared with a third party for cross-context behavioral advertising purposes. Please cease and refrain from sharing my personal information for such purposes.

I wish to withdraw from the Company’s financial incentive or loyalty rewards program Ambassador360. Please delete my account. I understand that by withdrawing from the program and having my account deleted, I will not be receiving any of the financial incentives, rewards, benefits or discounts that I may have previously earned or accrued as a member of this program. 

This request has been submitted through an agent on my behalf:
This agent has been authorized in writing to submit this request on my behalf:
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