CCPA REQUEST FORM

Submit a CCPA Request

In order to process your request, we need some basic information from you. The information requested in this form is important to the efforts of Island Capital Group LLC, C-III Capital Partners LLC and their subsidiaries and affiliates (collectively, the “Company”) to process your request.

Please note: If you choose not to provide the information requested in this form, we will be unable to process your request and will take no further action.

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Name

First

Last

What type of request are you making?

Please provide any information that might be helpful in fulfilling your request in regards to how you have engaged with C-III Capital Partners.

The Company takes your right to privacy seriously. In order to fulfill this request, the Company will need to reasonably validate that you are the owner of the account for which this request is being submitted. This may require additional follow-up to ensure confidence that this request can be fulfilled. We will work to fulfill this request in a timely manner that complies with the legal requirements in your jurisdiction.

Please read and select the applicable option below:

I DECLARE UNDER PENALTY OF PERJURY THAT I AM A RESIDENT OF CALIFORNIA AND THE INDIVIDUAL CONSUMER WHOSE PERSONAL INFORMATION IS THE SUBJECT OF THE REQUEST.
I DECLARE UNDER PENALTY OF PERJURY THAT I AM THE AUTHORIZED AGENT OF THE INDIVIDUAL WHOSE PERSONAL INFORMATION IS THE SUBJECT OF THE REQUEST. I UNDERSTAND I WILL BE REQUIRED TO PROVIDE WRITTEN PROOF OF MY STATUS AS THE INDIVIDUAL'S AUTHORIZED AGENT AND ADDITIONAL INFORMATION TO CONFIRM MY IDENTITY.

I acknowledge that transmitting personal information over the internet or via mail comes with inherent risks including the risk that the information will be exposed to unauthorized individuals. I understand the risks associated with my chosen method for sending and receiving information pertaining to my request.