CCPA Request Form for California Residents

    1. Consumer Information

    2. Type of Request

    3. Who is submitting this form?

    4. Confirmation and Signature

    Which type of request are you making?

    Access request: I want to know the categories of information that Archenia has about meAccess request: I want to obtain a copy of specific personal information that Archenia has about meDeletion request: I want my personal information removed

    Who is submitting this form?

    I am the consumerI am an Authorized Agent acting on behalf of the consumer

    Provide signature below

    By signing below and clicking “Submit” after reviewing your entry, I declare under penalty of perjury that: (1) I am duly authorized by the California resident on behalf of whom this request is being submitted; and (2) the information submitted is true and correct.