California Residents Consumer Request Form

If you are a resident of California, and you want to submit a request to EG America, LLC and its subsidiaries please fill out this webform below.

If we require more information from you, or need clarification about the nature of your request, we will contact you at the email you indicate below. We will also use the email address and street address you provide below as a means to verify your request. For information about how we handle personal information of California residents, please visit our Privacy Notice.

For certain requests, we may ask for additional information or documents to verify the identity of the consumer who is the subject of the request. The information provided through this form will be used to respond to your request, including verifying identity, identifying personal information responsive to your request, and keeping records of your request.

Consumer First Name *

Consumer Last Name *

Consumer Reply Email Address

Consumer Street Address *

Consumer City of Residence *

Are you the consumer? *

Yes, I am making a request related to personal information about me.
No, I am acting as an authorized agent for the consumer. I have attached one of the following, completed and signed by the consumer: (1) a signed authorization of the consumer; or (2) a Power of Attorney pursuant to California Probate Code §§4121 to 4130.

Specify the request(s) - check all that apply *

Request to know categories of personal information EG America has collected, used, disclosed, and/or sold about the consumer.
Request to obtain specific pieces of personal information EG America has collected about the consumer.
Request to delete personal information EG America has collected about the consumer.
Request to opt out of the "sale" of personal information about the consumer.

Verification *

By submitting this form, I hereby certify that this request is being made by or on behalf of a current resident of California.
By submitting this form, I hereby certify under the pains and penalties of perjury that the information entered into this form is complete, accurate, and up-to-date, and that I am the consumer who is the subject of the request or have been authorized by that consumer to act on his/her behalf, as indicated above. I understand that it will be necessary for EG America to verify the identity of the consumer and/or authorized agent for this request, and additional information may be requested for this purpose.

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