Who is the consumer to whom this request applies?

First Name *

Last Name *

Email Address *

Phone Number *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Country *

Are you a CommunityAmerica member? *

If you are not member of CommunityAmerica Credit Union, help us facilitate your request by providing how you have interacted with CommunityAmerica.

What type of request would you like to submit? *

Request to Know

By checking here, you request to know what personal information CommunityAmerica has collected about you, may have shared with others, or otherwise has in its possession.

Request to Delete

By checking here, you request that CommunityAmerica delete all personal information about you that we have collected and used, and that we direct all third parties to which we have provided such information to likewise delete such information. You understand that by submitting a request to delete, you are opting out of all Marketing communications going forward.

Are you acting on behalf of another person?

If you are submitting a request on behalf of someone else, be advised that document(s) proving your right to act on that person’s behalf (e.g. power of attorney, proof of guardianship) will be requested.

Yes, I'm acting on another's behalf.

Legal Agreement *

By submitting this request, you assert, under penalty of perjury, that (1) you are either making this request on your own behalf or have the lawful authority to act on behalf of the person identified above; and (2) to the best of your knowledge, information and belief, the person identified above qualifies as a California Consumer covered under the CCPA or a European Union Consumer under GDPR.

I agree.

Electronic Signature *