CCPA Request Form

If you are a California resident, you can request information on the California Consumer Privacy Act (CCPA) by completing the form below. Please provide all information and click submit.
Your full name as it appears on your credit card:
Your home address:
Street
City
State
Zip
Last 4 digits of your Social Security Number
Last 4 digits of your Account Number
This option is only available to California residents


*Obtaining Your Card: The USA PATRIOT Act is a federal law that requires all financial institutions to obtain, verify and record information that identifies each person who applies for a card account. What this means for you: When you apply for a card account, we will ask for your name, address, date of birth and other information that will allow us to reasonably identify you. We may also ask to see your driver's license or other identifying documents at any time.

Revel®, FIT, Verve® and Cerulean® - Mastercard and the Mastercard® acceptance mark are service marks used by The Bank of Missouri under license from Mastercard International. Cards are issued by The Bank of Missouri and serviced by Continental Finance Company.

Reflex® and Surge® - Mastercard and the Mastercard® acceptance mark are service marks used by Celtic Bank under license from Mastercard International. Cards are issued by Celtic Bank and serviced by Continental Finance Company.