Exercising Your Rights Under California Laws We are committed to individual privacy rights and providing the highest level of customer service. If you are a California resident wishing to exercise your rights under California law, including the CCPA, please complete the following form, select the options that apply to your request(s), and click the “Submit” button. We will promptly respond to your request. You are not required to provide all of the information listed below, but we may not be able to respond to your request or provide you with information if we cannot verify your identity or authority. We may contact you to request more information. We will only use the information you provide to verify your identity or authority to make a request and to respond to your request. For more on our general privacy practices, please review our privacy policy. Please complete all required fields * Requestor’s Name* First Last Requestor’s Company (if any) Requestor’s Email* Requestor’s Phone Number* Requestor’s Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Côte d'Ivoire Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Réunion Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu US Minor Outlying Islands Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Åland Islands Country Please indicate if you are exercising a right yourself, exercising a right on behalf of your minor child, or if you are acting as an authorized agent on behalf of another* Exercising a right myself Exercising a right for my minor child Acting as an authorized agent If you are exercising a right on behalf of your minor child what is the child's name First Last If you are acting as an authorized agent what is the name of California resident on whose behalf you are acting First Last Preferred Method of Contact (check all that apply):* Email Telephone Mail Rights You Are Exercising (check all that apply)* Right to Know Right to Delete Right to Opt Out Shine the Light request Additional Comments We may contact you via the information you have provided above and ask for additional information to verify your identity or authority. We will notify you if your request has been granted or declined, or if an exception applies to your request. If you need assistance or have questions regarding your individual rights request, please contact us at 855-828-7229 or caprivacy@fnba.com. Routing Number: 072412435 Privacy Policy | GLBA Privacy Notice | Do Not Sell My Information | Contact ©2020 First National Bank of America, Member FDIC, Equal Housing Lender NMLS#413209 UP DOWN