CCPA Request

CCPA Request Form

Instructions

IMGE, LLC (“IMGE”, “Company”, “us”, or “our”) respects your individual rights provided by the California Consumer Privacy Act (CCPA) and we will respond to all requests from California consumers or households as required by law. We ask that you complete and submit this form so that we have a written record of your request and that we can promptly respond. Alternatively, you may also email us at [email protected].

IMPORTANT NOTE: Please know that we may not be obligated to provide access to or delete the personal information we have collected about you if your request conflicts with federal or state law or other lawful obligations or is subject to any of the exemptions in the CCPA. In addition, we need only search our records for the preceding 12 months.

Request Details

Please complete the information as accurately and honestly as possible. If you have any questions, please contact us at [email protected].


To help us honor your rights, please specify your primary residency and applicable data privacy law.
Select one:
  • California Consumer Privacy Act (CCPA)
  • Other – I would like to exercise different rights, which I will describe below.
To help us initiate this request, we need some basic information about you.
Select all that apply:
  • User/Customer/Subscriber
  • Visitor
  • Authorized Agent – If you have written/signed authorization on either a User, Customer, Subscriber and/or Visitor, please select this option. If the request is regarding a California User and/or Visitor, be sure to provide evidence of California consumer authorization and your registration with the State of California when submitting this form; otherwise, delays will result.
  • Other
  • I am a resident of California.
If IMGE has any of your personal data, you may have specific rights depending on what data privacy laws may apply. Please specify your request so that we can honor your rights.
Select all that apply:
  • Access – I want to know what personal information IMGE has collected on me
  • Update – I want to update (e.g., correct/clarify) my personal information
  • Delete – I want IMGE to delete some/all personal information about me
  • Know – I want to know what categories of personal information IMGE collects about me, the categories of third parties to whom the personal information was disclosed, and the associated business purpose(s), within the preceding 12 months
  • Unsubscribe – I want to opt-out of receiving IMGE marketing communications
  • Port – I want to transfer my personal information collected by IMGE to another party
  • Consent – I want to withdraw my consent (If applicable)
  • Complaint – I want to file a complaint with IMGE
  • Other
Please let us know the best way to reach you.
Email - I want IMGE to use the following email address to reach me:
Other – I want IMGE to contact me in another way described below:
  • By submitting this form, I certify and declare under penalty of perjury under the applicable law(s) that I am the consumer (or authorized agent) whose personal information is the subject of this request.