Gramm Leach Bliley Act
Sample Notice A - Initial Privacy Notice
In connection with your transaction, [name of dealership] may obtain information about you as
described in this notice, which we handle as stated in this notice.
- 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 - We restrict access to nonpublic personal information about you to [provide an appropriate description, as to when the information will be disclosed such as “those employees who need to know that information 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.
- We may disclose all of the information we collect, as described above, to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. We may make such disclosures about you as a consumer, customer, or former customer. We may also disclose nonpublic personal information about you as a consumer, customer, or former customer, to non-affiliated third parties as permitted by law.
CUSTOMER ACKNOWLEDGMENT: I (we) acknowledge that I (we) received a copy of this notice on the date indicated below.
| __________________________ Date |
________________________________________ Customer's Signature |
||
| ________________________________________ Customer's Name (printed) |
|||
| __________________________ Date |
________________________________________ Co-customer's Signature |
||
| ________________________________________ Co-customer's Name (printed) |