Request to Know

Your Name:

Your Mailing Address:

Daytime Phone Number:

Today's Date:

Information you are requesting:

The specific pieces of personal information we have about you The categories of personal information we have collected about you The categories of sources from which the information was collected The categories of personal information about you that we disclosed for a business purpose The categories of third parties to whom the personal information was disclosed The business or commercial purpose for collecting or disclosing personal information Other information, please describe:

We will respond regarding information we have collected in the preceding 12 months. We will acknowledge your request within 10 days, and provide the information within 45 days. If we are not able to complete your request within 45 days, we will notify you of such, and complete your request within 90 days of receipt of the original request.

You may also download this form and submit it in person at any of our branches, or call us at (888) 831-5295