IMPORTANT
PRIVACY CHOICES REGARDING YOUR NON PUBLIC PERSONAL
INFORMATION
Your
nonpublic personal information may be disclosed for the purpose of offering
products or services to you.
We
collect nonpublic personal information about you from:
Applications or other forms you complete;
Your business dealings with us
and our companies;
Consumer reporting agencies; and
Claims databases, such as the
Comprehensive Loss Underwriting Exchange.
We
may share nonpublic personal information about you, including:
Information from your application or other forms,
such as your name, date of birth, address, age, social security number;
Information about your transactions with us, our
affiliates or others, such as your policy coverage, premiums and payment
history; and
Information from consumer
reporting agencies, such as your credit history.
We
may share your nonpublic personal information with:
Our affiliated companies,
which means any person or entity that is an affiliate of,
or related by common ownership,
or affiliated by corporate control, with us;
Financial companies, such as
mortgage bankers and automobile insurers.
Rest
assured, we protect your nonpublic personal information. The only employees who have access to that
information are those who must have it to provide products or services to
you. Additionally, you have the right
to access and to request correction of your recorded nonpublic personal
information. Simply contact us if you
would like to access or correct your nonpublic personal information.
Nonetheless,
under certain circumstances, you have the right to prevent the disclosure of
your nonpublic personal information. This is known as ‘opting out.’
If
you don’t want us to disclose nonpublic personal information about you to
nonaffiliated companies, you may tell us so by ‘opting out.’ If you wish to opt out check the option at
the bottom of this form. You may opt
out at any time. Even if you opt out,
we may still disclose information as allowed by law.
I
have received and read the above notice and I understand and agree to its
provisions.
Signature:_____________________ Date:__________
I
choose to opt out: _____
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