FOR CALIFORNIA RESIDENTS ONLY In order to complete your request, please help us identify you in our system by filling out the following information. Residents of other states are not entitled to use the following form.*denotes required fields *First Name *Last Name *Email *Phone *Street Address *City *State —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY *Zip Code Please select one: * Do not sell my information to third parties Users with disabilities (and any other users) who wish to opt-out of the sale of their personal information can also contact us by emailing us at: [email protected]; calling us at: (812) 247-0986; or sending us U.S. mail to: 326 E Court Ave Suite 102, Jeffersonville, IN 47130. If we have a good-faith, reasonable and documented belief that a request to opt-out is fraudulent, we may deny the request. Where you make a request to opt-out of the sale of your personal information through an authorized agent, we will require that you or the authorized agent provide us with a valid written authorization executed by both parties, with the validity of such document determined by us in our reasonable, good faith discretion. Please submit such documentation to us at: [email protected], or 326 E Court Ave Suite 102, Jeffersonville, IN 47130. For additional discussion of your privacy rights, please visit the: Privacy Policy