CCPA Request Webform

If you are a resident of California, and you want to submit a request to PJ's Coffee under the California Consumer Privacy Act (CCPA), please fill out this webform below.

First Name*
Please enter your first name.
Last Name*
Please enter your last name.
Email*
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Please enter your email address.
Phone*
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Please enter your phone number.
Request Type
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*indicates required field

By submitting this request I declare under penalty of perjury that I am a resident of California and the consumer whose personal information is the subject of the request.