California authorized agent designation

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California Consumer Privacy Act

California residents have the right to designate an authorized person or corporate entity 1 to exercise rights granted to them under the California Consumer Privacy Act (“CCPA”). To make this designation, California residents may complete and submit this form to Fromm International, Inc., (“Fromm”).

If we are unable to verify the identity of the person submitting this form, we may request additional information from the person making the submission. Authorized agents that have been provided a power of attorney from a consumer may submit requests directly on behalf of that consumer so long as proof of such power is submitted along with the consumer request form.

Consumer’s Information

California Authorized Agent Designation

First name(Required)

Last name(Required)

Email(Required)

Mailing address(Required)

City(Required)

State/Region(Required)

Postal Code(Required)

Phone number(Required)

Check if State of Residence is California or was in the immediate last 12 months

Check if State of Residence is California or was in the immediate last 12 months*

*Asterisks indicate required fields. The CCPA and this Agent Designation Form applies to California Residents (including those in the immediate last 12 months and from January 1, 2022 only). 1 If designating an entity to act on your behalf, we require that such entity be registered with the California Secretary of State. Fromm will not provide information to unregistered agents.

Authorized Agent’s Information

First name(Required)

Last name(Required)

Email(Required)

Mailing address(Required)

City(Required)

State/Region(Required)

Postal Code(Required)

Phone number(Required)

By signing below, I authorized the agent identified above to make the following types of requests on my behalf to Fromm.

Request to know the categories of personal information Fromm collects about me.

Request to know the specific pieces of personal information Fromm collects about me.

Request to delete the personal information Fromm collects about me.

Request to opt-out of the sale of my personal information.

Please deliver any information requested by my authorized agent to:*

Me

My authorized agent

Date

Consumer’s Name(Required)

Please complete all the fields in this form and submit by clicking the button below.

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