Personal Information Request Form for California Residents

The California Consumer Privacy Act and the California Privacy Rights Act only apply to California residents. To submit a request using this form, you must be a California resident.

You can request more information about the data we’ve collected from you.

Tell us what kind of request you’d like to make (Request to know categories of personal information, Request to access specific personal information, Request to correct inaccurate personal information, Request to delete personal information, Request to limit use of sensitive personal information).
We will make reasonable efforts to provide a response within 45 days of receiving your request and will contact you if the response requires additional time.

Authorized agents should fill out this form with information about the consumer to whom the request relates and provide their own name, phone number, email address and relationship with the consumer in the ‘Additional information about the nature of your request’ box.

We need some information to process your request. Please enter your information below. All fields marked with * are required.

For more information about the Mizuho California Privacy Notice, please click here.

You can exercise the right to opt-out of sales and sharing of personal information through the “Do Not Sell or Share My Personal Information” link below.

First name * Please complete this required field. First name must be between 2 and 30 characters. First name must be formatted correctly.

Middle name Optional Please complete this required field. Middle name must be at least 0 characters. Middle name must be formatted correctly.

Last Name * Please complete this required field. Last Name must be between 2 and 40 characters. Last Name must be formatted correctly.

Email * Please complete this required field. Email must be between 0 and 40 characters. Email must be formatted correctly.

Home address * Please complete this required field. Home address must be between 0 and 40 characters. Home address must be formatted correctly.

City * Please complete this required field. City must be between 0 and 40 characters. City must be formatted correctly.

State * Please complete this required field. State must be between 0 and 40 characters. State must be formatted correctly.

Zip code * Please complete this required field. Zip code must be at least 0 characters. Zip code must be formatted correctly.

Date of birth * Please complete this required field. Date of birth must be at least 0 characters. Date of birth must be formatted correctly.

Your relationship with Mizuho Please select an option from the dropdown menu.

What type of request would you like to make? * Please select an option from the dropdown menu.

Additional Information about the nature of your request Please complete this required field. Additional Information about the nature of your request must be at least 0 characters. Additional Information about the nature of your request must be formatted correctly.

Please complete all required fields.

Personal Information Request Form for California Residents

Thanks for your submission.