Opt-Out Form for California Residents California Resident Verifiable Request Form Please enable JavaScript in your browser to complete this form.Your Name *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone Number *Email AddressAre you a customer of Veros Credit:Choose an itemYesNoIf yes, what is your account number:CheckboxesBy checking this box, you (the requestor) declares under the penalty of perjury that the foregoing is true and correct, and that you are the consumer whose personal information is the subject of the request.What is your request? *How would you like us to respond to you?EmailRegular MailTerms *I have read and agree to the Terms of Service *By checking this box, you confirm that the information entered is complete and accurate, and you consent and authorize Veros Credit and its employees to contact and respond directly to your inquiry at the phone number and email address provided by e-mail, text message, and/or voicemail, and by using prerecorded/artificial voice messages and automatic telephone dialing systems. You further agree that the response to your inquiry will be made through electronic record in lieu of a record provided or made available on paper or in nonelectronic form.EmailSubmit
