In accordance with the California Consumer Privacy Act as amended by the California Privacy Rights Act (“CCPA”), you may be able to exercise certain data rights regarding your personal information.  Please complete this form to submit your request.  For more information about these rights, please see our California Personnel Privacy Notice or our California Job Applicant Privacy Notice, as applicable.

In some cases, we may require additional information if we are unable to verify your request based on the information you have provided.  The personal information submitted in connection with this request will be used to process your request.

Fields marked as required must be completed in order to submit this form.  Complete the fields below using the consumer’s information.

Select the consumer right you would like to exercise:

Authorized Agents Only

If you’re an Authorized Agent submitting a request on behalf of an individual, you must attach written authorization from the individual indicating you’ve been authorized to submit a request on the individual’s behalf. The form must be signed by both you and the individual. All forms not signed will be rejected.

Accepted file types: docx, pdf, Max. file size: 1 MB.

Note that you also have the right to appeal our decision in the event that we decline to take action on a request exercising one of your rights set forth above.

By submitting this request, I am confirming the following:

1. Accuracy: The information I have provided is true and accurate;

2. Privacy: I understand the information will be processed by Telos® in accordance with our California Personnel Privacy Notice or our California Job Applicant Privacy Notice, as applicable;

3. Contact: Telos has the right to contact me to verify my identity and to process this request.