HTT
INSURANCE GROUP
HTT Agency, Inc.
Fox Insurance Agency
Privacy Policy
Notice (As of June 30, 2001)
PURPOSE OF THIS NOTICE
Title V of the Gramm-Leach-Bliley
Act (GLBA) generally prohibits any financial institution,
directly or through its affiliates, from sharing nonpublic
personal information about you with a nonaffiliated
third party unless the institution provides you with
a notice of its privacy policy and practices, such as
the type of information that it collects about you and
the categories of persons or entities to whom it may
be disclosed. In compliance with the GLBA, we are providing
you with this document, which notifies you of the privacy
policies and practicies of this agency.
The GLBA further requires that we
inform that you have a right to prevent us from sharing
nonpublic personal information about you with a nonaffiliated
third party for any purpose that is not specifically
authorized by law. Your right to prevent us from sharing
nonpublic personal information about you with a nonaffiliated
third party for a purpose that is not specifically authorized
by law is called your right to "opt-out" of
such information sharing.
1. Information we collect:
We collect nonpublic personal information
about you from the following sources:
- Information we receive from you on
applications or other forms.
- Information about your transactions
with us, our affiliates or others.
- Information we recieve from a consumer
reporting agency.
Unless it is specifically stated
otherwise in an amended Privacy Policy Notice, no additional
information will be collected about you.
2. Information we may disclose to third parties:
We may disclose all of the information
that we collect about you, as described above.
3. Disclosures to nonaffiliated
third parties:
A. Nonaffiliated Third Parties to
Whom Disclosures May Be Made:
We may disclose nonpublic personal
information about you to the following types of third
parties, unless you tell us not to:
- Financial service providers, such as
life insurers, automobile insurers, mortgage bankers,
securities broker-dealer and insurance agents;
- Non-financial companies, such as retailers,
direct marketers, and publishers, and
- Others, such as nonprofit organizations.
We may disclose nonpublic personal
information about you to nonaffiliated third parties
as permitted by law.
B. Notification of Your Right to
Opt-Out of certain disclosures:
As we have indicated in this Privacy
Policy Notice, we collect certain nonpublic personal
information about you , and we may disclose that information
to certain nonaffiliated third parties for purposes
other than those expressly permitted by the Gramm-Leach-Bliley
Act and the federal and state regulations implementing
the Act. If you prefer that we not disclose nonpublic
personal information about you to nonaffiliated third
parties, you may opt-out of those disclosures, that
is, you may direct us not to make those disclosures
(other than those disclosures that are expressly permitted
by the Gramm-Leach-Bliley Act and its implementing regulations).
If you wish to opt-out of such disclosures
to nonaffiliated third parties, you may check the appropriate
box on the attached form and return as indicated.
4. Affiliates with whom
we share certain information protected by the Fair Credit
Reporting Act, unless you tell us not to:
A. Information we can share with
our affiliates, unless you opt-out:
Unless you tell us not to, we may
share with our affiliated companies information about
you, including:
- Information we obtain from your insurance
application, such as your income or your marital status;
- Information we obtain from a consumer
report, such as your credit score or credit history;
- Information we obtain to verify representations
made by you, such as your open lines of credit; and
- Information we obtain from a source
regarding its employment, credit, or other relationship
with you, such as your employment history.
B. Our affiliated companies who may
receive this information are:
- Financial service providers, such
as mortgage lenders and brokers;
- Non-financial companies, such as retailers,
direct marketers, and publishers;
- Our other affiliates, such as nonprofit
organizations.
C. How to tell us not to share your
information:
If you prefer that we not share
this information with our affiliated companies, you
may direct us not to share this information by checking
the appropriate box on the attached form and return
as indicated.
5. Our practices regarding information,
confidentiality, and security:
We restrict access to nonpublic
personal information about you to those employees who
need to know that information in order to provide products
or services to you. We maintain physical, electronic,
and procedural safeguards that comply with federal regulations
to guard your nonpublic personal information.
6. Our policy regarding dispute
resolution:
Any controversy or claim arising
out of or relating to our privacy policy, or the breach
thereof, shall be settled by arbitration in accordance
with the rules of the American Arbitration Association,
and judgement upon the award rendered by the arbitrator(s)
may be entered in any court having jurisdiction thereof.
7. Reservation of the right to
disclose information in unforseen circumstances:
In connection with the potential
sale or transfer of its interests, this agency and its
affiliates reserve the right to sell or transfer your
information (including but not limited to your address,
name, age, sex, zip code, state and country of residency
and other information you provide through other communications)
to a third party entity that (1) concentrates its business
in a similar practice or service; (2) agrees to be this
agency's successor in interest with regard to the maintenance
and protection of the information collected; and (3)
agrees to the obligations of this privacy statement.
Opt-Out
Form
Please read the text below and decide
whther you wish to exercise your right to opt-out of
the information sharing described. If you choose to
exercies your right to opt-out, you must mailthis form
back to us at this address:
HTT Insurance
Group
HTT Agency, Inc.
Fox Insurance Agency
Main Office: 5879 Cheviot
Road, Cincinnati, OH, 45247
Your response must be postmarked
no later than 30 days from the date you received this
notice from us in person in order for it to be valid.
If you do not mail this form back or do not mail it
back within 30 days, you have not exercised your opt-out
right, and we can share the information described.
____ I wish to exercise my right
under the Gramm-Leach-Bliley Act to opt-out of this
agency's sharing nonpublic personal information about
me to nonaffiliated third parties for purposes other
than those permitted by law.
____ I wish to exercise my right
under the Fair Credit Reporting Act to opt-out of this
agency's sharing non-transactional information about
me to affiliates.
________________________
Customer Name (Please print)
___________________________
Customer Signature
_____________
Date
GLB Notice 0601
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