CCPA Personal Information Request Form

Thank you for your interest in paperless statements. As an FCC Finance customer (“FCC”), you have the right to have communications for your accounts at FCC provided or made available to you through one of the following methods free of charge: paper via postal delivery or electronically through an email account designated by you.

Customer Name*

Email Address*

Mailing Address*

Phone Number*

Consent*

By submitting this form, I agree to all of the statements outlined above.

I hereby request that you send communications for my accounts, including account statements, to the below email account designated by me. I acknowledge having read and I agree to the terms of FCC’s Electronic Communications Disclosure, which applies to my consent to receive communications electronically.

CCPA Personal Information Request Form

Step 1 of 4

My information

Asserting a Right for (if applicable)

FCC Finance, LLC

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