"Limit the Use of My Sensitive Personal Information" Opt-Out Submission Form

Your Information (As Authorized Agent Submitting on Behalf of Another Person)

First Name of Agent *

Middle Initial of Agent

Last Name of Agent *

Suffix of Agent (optional)

Date of Birth of Agent *

Phone Number of Agent *

Email Address of Agent *

Street Address of Agent (No PO Box) *

Apartment or Unit Number of Agent

City of Agent *

State of Agent *

ZIP Code of Agent *

How do you, the Agent, want to receive our response? * We will use this preferred method of communication to send our response and other communications concerning your request to the email or postal mail address you entered above. Email Address of the Agent Postal Mail address of the Agent

How are you authorized to submit this request on behalf of another person? * The person for whom I am submitting this request has signed permission demonstrating that I have been authorized by them to act on their behalf. I have a power of attorney pursuant to Probate Code sections 4121 to 4130. The person for whom I am submitting this request is my minor child, who is under 18 years of age, over which I have custody and am their parent or guardian. I am the conservator for the person for whom I am submitting this request.

We need to verify your identity as authorized agent, and the written authorization from the person on whose behalf you are submitting this request. Please submit a copy of your government issued identification card, and the signed permission or power of attorney, as applicable, to this email address: CCPAConsumerReply@orangecountyscu.org or by postal mail to Orange County's Credit Union, PO Box 11777, Santa Ana, CA 92711-1777, Attention: CCPA Request, or by hand delivery at one of our local branches. We may require additional information from you concerning your identity or the authorization.

About the Person (the "Consumer") for Whom You are Submitting this Opt-Out Request

First Name of Consumer *

Middle Initial of Consumer

Last Name of Consumer *

Suffix of Consumer

Date of Birth of Consumer *

Phone Number of Consumer *

Email Address of Consumer *

Street Address of Consumer (No PO Box) *

Apartment or Unit Number of Consumer

City of Consumer *

State of Consumer *

ZIP Code of Consumer *

Is the Consumer a California resident? * No, the Consumer is not a California resident Yes, the Consumer is a California resident

Unfortunately, we cannot fulfill your request.

Following California law, CCPA requests are only accepted for California residents. If you have questions, please refer to our Online Privacy Policy.

What is the relationship of the person on whose behalf you are submitting this request (the “Consumer”) with Orange County's Credit Union? * The Consumer is a Current or Joint Member The Consumer is a Former Member or previously applied for an account or loan The Consumer was never a Member and never applied for an account or loan

Does the Consumer have any other relationship with Orange County's Credit Union? Employment of Consumer: Either a current employee, previously applied for employment, but never hired, or a contractor of Orange County's Credit Union Other (for Consumer)

If you have selected "Employment of Consumer" or "Other (for Consumer)," please explain the nature of the Consumer's relationship with Orange County's Credit Union.*

How does the Consumer prefer to be communicated with? * We will use this preferred method of communication to communicate with the Consumer, using the email of the Consumer or postal mail address of the Consumer you entered above. Email address of the Consumer Postal Mail address of the Consumer

The safety of your personal information is very important to us. That’s why we keep it protected with security features. Information you provide in this CCPA request is being collected solely for the purpose of submitting the request. To learn more about how we safeguard personal information, please view our Online Privacy Policy.