Hall & Clark Insurance Agency Inc.
July 1, 2001
PURPOSE OF THE NOTICE
Title V of the Gramm-Leach-Bliley Act (GLBA) generally prohibits any financial institution, directly or through it's affiliates, from sharing nonpublic personal information about you with a nonaffiliated third party unless the institution provides you with a notice of its privacy policies 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 practices of Hall & Clark Insurance Agency, Inc.
The GLBA further requires that we inform you 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.
Our Privacy Policies and Practices
- 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 receive from a consumer reporting agency.
- Information we may disclose to third parties:
We may disclose all of the information we collect, as described above, about our Customers or former customers, to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. We also may disclose information about our customers or former customers as permitted by law.
- Nonaffiliated third parties to whom disclosures may be made:
3A. We may disclose nonpublic personal information about you, such as we have described above, to the following types of third parties that perform marketing services on our behalf or with whom we have joint marketing agreements:
Financial institutions with whom we have joint marketing agreements, such as:
- securities brokers or dealers;
- investment companies; and
- insurance providers
We may also disclose nonpublic personal information about you to nonaffiliated third parties as permitted by law.
If you wish to opt out of such disclosures to nonaffiliated third parties, you may fill out and mail it back to the address shown on this notice.
- Affiliates with whom we share certain information protected by the Fair Credit Reporting Act, unless you tell us not to:
4A. Information we can share with our affiliates, unless you tell us not to: 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 representation made by you, such as your open line of credit; and
- Information we obtain from a person regarding its employment, credit, or other relationship with you, such as your employment history.
4B. Our affiliated companies who may receive this information are:
- Financial service providers, such as: Finance Companies; Insurance Companies & Insurance Brokers (Managing General Agencies); United Agency of Kentucky, LLC.
4C. How to tell us not to share this information with our affiliated companies: If you prefer that we not share this information with our affiliated companies, you may direct us not to share this information with our affiliated companies you direct us not to share this information by doing the following:
- Fill out and tear off the bottom of this sheet and mail it back to the address shown on this notice.
- 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 information.
- Our policy regarding dispute resolution:
- Reservation of the right to disclose information in unforeseen circumstances:
In connection with potential sale or transfer of its interests, Hall & Clark Insurance Agency and its affiliates reserves 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 that 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 Hall & Clarks Insurance 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.
- Customer acknowledgement and signature:
Please read the text below and decide whether you wish to exercise your right to opt-out of the information sharing described. If you choose to exercise
your right to opt-out, you must mail this form back to us at PO Box 508, Prestonsburg, KY 41653. 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-Bailey Act to opt-out of Hall & Clark Insurance 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 Hall & Clark Insurance Agency's sharing nontransactional information about
me to affiliates.
Customer Signature Date
Hall & Clark Insurance Agency
- Hall & Clark Insurance