Dec 102020

CCPA OPT OUT REQUEST FORM

Consumer Request Submission Form for California Residents

Thank you for contacting Mercedes-Benz U.S. International (MBUSI). California residents may use the this form to submit a consumer rights request under the California Consumer Privacy Act of 2018.

Please fill-in the fields below (all are required) and click the "SUBMIT" button to make your Privacy inquiry.

For more information about our privacy practices, please refer to our MBUSI Privacy Policy page.

First Name(*)

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Last Name(*)

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E-mail Address(*)

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State of Residence(*)

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BY SUBMITTING THIS FORM, I CONFIRM THAT I AM A RESIDENT OF CALIFORNIA AND THAT THE INFORMATION I HAVE PROVIDED IS COMPLETE AND ACCURATE.

Antispam challenge(*)

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