CCPA Consumer Request Form
In order to respond to your request, the CCPA requires us to verify the identity of the Consumer exercising their rights under CCPA. Please provide the following information and ensure it matches the data SurePayroll currently has in its systems:
The following fields are optional and, if provided, may be used to assist SurePayroll in locating the Consumer:
I acknowledge that any false statement or other misrepresentation made on this form may subject me to civil and criminal penalties. I agree to indemnify and hold harmless SurePayroll, its affiliates and subsidiaries and each of their respective officers, directors, managers, members, employees and agents from any and all liability arising out of any fraudulent statements.
By submitting this form, I declare under penalties of perjury under the laws of the State of California that the foregoing information is true and correct.