CCPA Request Form

Thank you for submitting the CCPA Request Form!

We will get back to you as soon as we can.

Sorry, we are unable to process your request. For more information, please contact  (877) 984-5328.
I am submitting this request on behalf of *
Please enter your full name.
Please enter your date of request with current or future date.
Additional Contacts:

Can you confirm you are an authorized agent on behalf of the written member(s) of your household? *

Please choose an option

If you marked “No” above, your CCPA request to know, delete, and/or correct personal information on behalf of your household will be declined.

Are you a resident of California? *

Please choose an option

If you marked “No” above, you do not have any rights under the CCPA and we will therefore not respond to this submission.

Are you a member with Logix Federal Credit Union? *

Please choose an option

If you marked “Yes” above, please provide your membership number (optional):

Please enter your membership number with numbers only.

Do you have Online Banking with us? *

Please choose an option

If you marked “Yes” above, have you shared your username and password with anyone else?

Are you a past or current employee? *

Please choose an option
Contact Information:
Please enter your e-mail address.
Please enter your phone number.
Please enter your home address.
Please select a method of contact.

* You authorize us to contact you and/or your authorized agent (if applicable) for identity verification purposes in accordance with our legal obligations.

Please select all of the following that apply to your request:

Type of Request:

1. Request to Know (please check all that apply to your request): *

2. Request to Delete Personal Information? *

Please choose an option

3. Request to Correct Personal Information? *

Please choose an option

Please submit any documents that you would like us to consider in support of your request for us to correct the contested personal information to [email protected]. We may require additional documentation from you regarding the contested personal information. We may deny your request if we determine that the contested personal information is more likely than not accurate based on the totality of circumstances.

If for any reason we are unable to correct, would you like us to consider deleting the information instead? *

Please choose an option
Note About Identity Verification:

We will need to verify your identity. If you are an authorized agent for the above referenced consumer or an authorized agent submitting the request for members of your household, we will request a copy of your government-issued identification card, and written authorization from the consumer to submit the request. Additional details will be provided to you or your authorized agent (if applicable) regarding what we need to verify you and your request within 10 business days of submission of this form.