California Consumer Privacy Act Request Form

California residents may choose one of the options below to submit a request to Hilco Receivables, LLC under the California Consumer Privacy Act (CCPA).


I understand that your response(s) to my request will be in writing and I authorize you to provide your response(s), send verification of receipt of my request, or contact me in connection with my request, using the following contact information and method(s) of delivery:


I understand that you need to be reasonably sure that I am making this request regarding my own information, or that I am authorized to make a request regarding someone else’s information. Therefore, I am providing the information below, which is accurate to the best of my knowledge, so that you can attempt to verify my request. I understand that you will use the verification data provided to cross-check information available in your records to the extent possible, and that you may require additional documentation if I am not making the request for my own information, and/or may deny my request if the information provided is insufficient for purposes of verification. (Check appropriate box and provide associated verification information as applicable):

I request information or action regarding my own personal information

Please fill in each of the fields below:


The nature of my request is as follows, and I understand that I am only permitted to make a verifiable consumer Request to Know or Request to Access regarding my data under the CCPA twice in any 12-month period. (Check appropriate box and provide associated information as applicable).

Select a choice

I would like to know, for the past 12 months:

  • The categories of Personal Information you have collected about me;
  • The categories of sources from which that Personal Information was collected;
  • The business or commercial purpose for the collection or sale;
  • The categories of Third Parties with whom you shared the Personal Information;
  • The categories of PI you sold in the preceding 12 months and associated categories of third parties to whom the PI was sold; and
  • The categories of Personal Information you disclosed for a business purpose and associated categories of Third Party to whom it was disclosed.

Select a choice

I would like to receive a copy of the Personal Information collected about me for the past 12 months. Unless otherwise noted here, I would like to receive copies of all such information. I am aware that certain information will not be disclosed to me, even if my CCPA request is verified, such as a social security number, driver’s license number, government-issued identification number, financial account number, or health insurance or medical identification number. I am also aware that you are not required to disclose specific pieces of Personal Information to me, as opposed to categories, unless I provide to you a written declaration under penalty of perjury stating that I am the consumer whose Personal Information is the subject of this request.

IMPORTANT – ADDITIONAL DOCUMENTATION REQUIRED: We require that you submit proof of your identity before we can disclose specific pieces of Personal Information. Please submit a Declaration, signed under Penalty of Perjury, confirming you are the consumer whose personal information is at issue in your request.

The Declaration can be emailed to, or mailed to us at:

Hilco Receivables, LLC
Attn: Compliance
5 Revere Drive, Suite 420
Northbrook, Illinois 60062

Please include your CCPA request reference number (which we will provide to you after you submit this request), when submitting your Declaration.

Select a choice

I would like the Personal Information collected about me to be deleted. Unless otherwise noted here, I would like you to delete all such information.

We do not “Sell” your “Personal Information” to “Third Parties,” as those terms are used in the CCPA, which is why there is no option to submit a request to opt out of such sales.

If you have any questions about this form or your CCPA rights, you may contact us by telephone at 877-201-2557 or email us at

Our Privacy Policy, with additional information about the CCPA, is also available online at:

Please Click Below to Submit Your Request