1. Who are you making this request on behalf of: Self. Please go to Question #2Agent for a requestor. Please go to Question #3.
2. If you are making this request on behalf of yourself, are you a California resident? Yes. Please go to Question #5.No. Please go to Question #7.
3. If you are an agent for the requestor, is the requestor a California resident? Yes. Please go to Question #4.No. Please go to Question #7.
4. If you are an agent for the requestor, do you have signed written authorization permitting you to act on behalf of the requestor? Yes. Please upload a copy of the written authorization. Please go to Question #5 after uploading the authorization.No. Please go to Question #5.
5. Please check the box that best describes the relationship between CBC and you OR CBC and the requestor. You may check more than one box, if applicable. CustomerFormer customerCurrent employeeFormer employeeJob applicantVendor/service providerWebsite visitor
i. Please state the type of account with CBC (ie., savings, checking, money market, certificate of deposit, etc.). ii. Please provide the full address associated with the bank account. iii. Please provide the date of the most recent online transaction or in-branch transaction with CBC.
i. Please state the type of account with CBC (ie., savings, checking, money market, certificate of deposit, etc.). ii. Please provide the full address associated with the bank account. iii. Please provide the date of the last online transaction or in-branch transaction with CBC.
i. What department do you OR the requestor work in at CBC? ii. Please state the job title. iii. Please state the manager’s full name.
i. What was the last date of employment at CBC? ii. Please state the job title. iii. Please state the manager’s full name.
i. Please state the date an application for employment was submitted to CBC (month and year). ii. Please state position applied for.
i. Please state the name of the vendor company.
i. Please provide the date (month, day, and year) of the most recent visit to CBC’s website. ii. Please provide one of the following pieces of information:
6. What request is being made to CBC? Right to KnowRight to DeleteRight to Correct
7. Please provide the email address or mailing address where you want us to contact you regarding this request.
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