CCPA Request Form

Submit a request under the California Consumer Privacy Act (CCPA)

CCPA Request Form

  • Are you making the request for yourself? is a required field
  • What is your relationship with First Bank? (If you are making a request for another person, please provide their relationship with First Bank) is a required field
  • First Name is a required field
  • Last Name is a required field
  • Email Address is a required field
  • Phone Number is a required field
  • Street Address is a required field
    • City is a required field
    • State is a required field
    • Zip Code is a required field
    • Type of Request is a required field
      By submitting this form, I confirm that the information I have provided is accurate. Please note this is an unsecure email communication. For your security, please do not include any sensitive personal or account information in your email.
      • reCAPTCHA is a required field