CCPA Form
This form is to be used to request that Bold Penguin d.b.a. Commercial Insurance Center remove data from our information systems on behalf of a consumer.
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Under the California Consumer Privacy Act, we are required to ask for a signed declaration under penalty of perjury if you are requesting copies of any information that we may have on you.
*
Yes, I would like to have a copy of any information that Bold Penguin has and I would like an electronic declaration be sent to me.
No, I simply want my information removed Bold Penguin's information systems.
Submit
Should be Empty: