California Consumer Rights Request Form If you are a California resident, you have certain rights under the California Consumer Privacy Act ("CCPA"). Upon submission of a verifiable consumer request, you have the right to request that a business that collects your personal information provide disclosures about or access to, in a portable and (if technically feasible) readily usable form, the specific pieces and categories of personal information that the business has collected about you in the past twelve (12) months (from the date of the business's receipt of the request); the categories of sources for that information, the business or commercial purposes for collecting the information; and the categories of third parties with which the information was shared. California residents also have the right to submit a request for deletion of their personal information under certain circumstances.*indicates a required field. FIRST NAME*MIDDLE NAME:LAST NAME:*Check All That Apply Request for Disclosure Request for Access Request for DeletionPlease describe your relationship to the VVPFI affiliate that collected your personal information (please list all categories that apply): (e.g., pre-need or at-need contract purchaser; pre-need contract beneficiary; next of kin/family member, website visitor; other; authorized agent of any of the above):RELATIONSHIP TO THE VVPFI AFFILIATE (OPTIONAL)If you are an authorized agent of a California resident and are making this request on his or her behalf, you will be required to provide a copy of the California resident's written authorization (for example a power of attorney) showing that you have been granted the authority to submit a consumer rights request on behalf of the California resident. You will be contacted at either the email address or mailing address you provide below, in order to request a copy of this document for verification purposes. To the extent that the written authorization provided to us is insufficient, we will contact you for further verification at the contact information you provide below. We may additionally contact the California resident in order to verify his or her identity and to confirm your authority to make a consumer rights request on his or her behalf, prior to responding directly to you.Additional Information needed to verify your identity for request processing* indicates a required fieldTODAY'S DATE (mm/dd/yyyy)ADDRESS 1ADDRESS 2CITYSTATE/PROVINCEPOSTAL CODEORDER NUMBER (IF KNOWN)DESCRIPTION/AMOUNT OF RECENT PURCHASE (IF KNOWN)DATE OF RECENT PURCHASE (IF KNOWN) (mm/dd/yyyy)CONTACT PHONE*##########CONTACT EMAIL*Please indicate how you would like to receive the information requested above by checking one of the following boxes. By mail (at Address above) By email (at Email above)ACKNOWLEDGEMENT *I understand that I may make a verifiable consumer request for disclosure or access twice within a twelve (12) month period. If I have submitted a request for deletion, I understand that, while I have the right to request deletion of my personal information, VVPFI or its affiliates may be able to retain some or all of the personal information for a variety of reasons, such as to comply with a legal obligation. I further understand that VVPFI or its affiliates will respond to my request as necessary using the information I provided above.* Payment options Submit Request If you are a human, do not fill in this field.