CALIFORNIA RESIDENT CONSUMER REQUEST FORM

To process your request, we ask that you kindly provide all of the following information:


First Name:
I Would Like More Information On:
Last Name:
Address:
City:
State:
Zip:
Phone Number:
Email Address:
 
I AM A (CHECK THE BOX(ES) AS APPLICABLE):
Prospective Customer Former Employee
Current Customer Current Employee
Former Customer Vendor / subcontractor
Other (please specify)

Please note that all of this information is requested in order for us to confirm your identify and process your request.

As a California resident, you have certain special rights regarding your personally identifiable information and any “personal information” as that term is described in the California Consumer Privacy Act. Such information is collectively referred to in this form as “personal information”.Please identify your request(s) (check the box(es) as applicable):

Disclosure of personal information collected / disclosed.
Deletion of personal information.
Opt-out of selling personal information.

We will ask for someadditional verification to comply with this request in order to protect your privacy. We may also need to request additional information from you to verify your identify and determine the propriety of your request, before we provide a substantive response. We cannot respond to your request or provide you with personal information if we cannot verify your identity or authority to make the request and confirm the personal information relates to you.

We endeavor to respond to a verifiable consumer request within forty-five (45) days of its receipt. If we require more time (up to 90 days), we will inform you of the reason and extension period in writing.The response we provide will also explain the reasons we cannot comply with a request, if applicable.

Any disclosures we provide will only cover the 12-month period preceding MBK's receipt of this request. For data portability requests, we will select a format to provide your personal information that is readily useable and should allow you to transmit the information from one entity to another entity without hindrance.

You may only make a verifiable consumer request for access or data portability twice within a 12-month period. These requests are free, though we reserve the right to implement a reasonable fee for excessive or complex requests you may submit.

Making a verifiable consumer request does not require you to create an account with us. We will only use personal information provided in this request form to verify your identity or authority to make the request.

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