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Data Request Form for California Resident Please complete the form below. We will use the information you provide on this form to facilitate your CCPA request. It is critical that all of your information is entered accurately to ensure optimal results. If you are a Power of Attorney and submitting a request, please send a letter containing the request type(s) (request to know, delete, and/or do not sell) to Comenity Bank at PO Box 182567, Columbus, OH 43218. *First Name *Last Name *Have you ever been known by another name? (Maiden, Aliases, etc.) *Address Line 1 Address Line 2 *City *State *ZIP Code *Phone Number (xxxxxxxxxx) *Date of Birth (MM/DD/YYYY) Select a date *Social Security Number (xxx-xx-xxxx) *Email Address *Confirm Email Address Your report will be sent to the address or email address indicated above, so please ensure it is correct. I don't have an email address *Request Type If you are an authorized agent submitting either a REQUEST TO KNOW or a REQUEST TO DELETE on behalf of someone else, we require verification of that person’s identity through the use of probative questions. You will be required to have the person for whom you are submitting the request be present with you in order to complete the request. If that person has provided you with a power of attorney that is authorized by the California Probate Code, please send a letter containing the request type(s) (request to know, delete, and/or do not sell) to Comenity Bank at PO Box 182567, Columbus, OH 43218. CANCEL CONTINUE © 2021 Comenity LLC.—Comenity Bank and Comenity Capital Bank are Comenity companies.

ABOUT RESOURCES FINANCIAL EDUCATION FAQ SEARCH YOUR ACCOUNT FREQUENTLY ASKED QUESTIONS Information for Comenity Customers Our most frequently asked questions and answers. Expand All + Common Questions About Comenity My Account COVID-19 Billing and Payments Applying for an Account Security and Fraud Protection Servicemembers Civil Relief Act (SCRA) Questions about your Comenity Direct CD or Savings account? Visit ComenityDirect.com Contact Financial Privacy Online & California Privacy Policy Terms of Service Do not sell my information © 2021 Comenity LLC.—Comenity Bank and Comenity Capital are Comenity companies. Feedback