19 MAC Pt. 1, R. 28.27
Appendix A- Sample Clauses
Cite as 19 Miss. Admin. Code Pt. 1, R. 28.27
Appendix A- Sample Clauses
Licensees, including a group of financial holding company affiliates that use a common privacy
notice, may use the following sample clauses, if the clause is accurate for each institution that
uses the notice. (Note that disclosure of certain information, such as assets, income and
information from a consumer reporting agency, may give rise to obligations under the federal
Fair Credit Reporting Act, such as a requirement to permit a consumer to opt out of disclosures
to affiliates or designation as a consumer reporting agency if disclosures are made to
nonaffiliated third parties.)
A-1 - Categories of information a licensee collects (all institutions)
A licensee may use this clause, as applicable, to meet the requirement of Section 7A (1) to
describe the categories of nonpublic personal information the licensee collects.
Sample Clause A-1:
We collect nonpublic personal information about you from the following sources:
1. Information we receive from you on applications or other forms;
2. Information about your transactions with us, our affiliates or others; and
3. Information we receive from a consumer reporting agency.
A-2 - Categories of information a licensee discloses (institutions that disclose outside of the
exceptions)
A licensee may use one of these clauses, as applicable, to meet the requirement of Section 7A (2)
to describe the categories of nonpublic personal information the licensee discloses. The licensee
may use these clauses if it discloses nonpublic personal information other than as permitted by
the exceptions in Sections 14, 15 and 16.
Sample Clause A-2, Alternative 1:
We may disclose the following kinds of nonpublic personal information about you:
1. Information we receive from you on applications or other forms, such as [provide
illustrative examples, such as "your name, address, social security number, assets,
income, and beneficiaries"];
2. Information about your transactions with us, our affiliates or others, such as
[provide illustrative examples, such as "your policy coverage, premiums, and
payment history"]; and
3. Information we receive from a consumer reporting agency, such as [provide
illustrative examples, such as "your creditworthiness and credit history"].
Sample Clause A-2, Alternative 2:
We may disclose all the information that we collect, as described [describe location in the notice,
such as "above" or "below"].
A-3 - Categories of information a licensee discloses and parties to whom the licensee
discloses (institutions that do not disclose outside of the exceptions)
A license may use this clause, as applicable, to meet the requirements of Sections 7A (2), (3),
and (4) to describe the categories of nonpublic personal information about customers and former
customers that the licensee discloses and the categories of affiliates and nonaffiliated third
parties to whom the licensee discloses. A licensee may use this clause if the licensee does not
disclose nonpublic personal information to any party, other than as permitted by the exceptions
in Sections 15 and 16.
Sample Clause A-3:
We do not disclose any nonpublic personal information about our customers or former customers
to anyone, except as permitted by law.
A-4 - Categories of parties to whom a licensee discloses (institutions that disclose outside of
the exceptions)
A licensee may use this clause, as applicable, to meet the requirement of Section 7A(3) to
describe the categories of affiliates and nonaffiliated third parties to whom the licensee discloses
nonpublic personal information. This clause may be used if the licensee discloses nonpublic
personal information other than as permitted by the exceptions in Sections 14, 15 and 16, as well
as when permitted by the exceptions in Sections 15 and 16.
Sample Clause A-4:
We may disclose nonpublic personal information about you to the following types of third
parties:
1. Financial service providers, such as [provide illustrative examples, such as "life
insurers, automobile insurers, mortgage bankers, securities broker dealers, and
insurance agents"];
2. Non-financial companies, such as [provide illustrative examples, such as
"retailers, direct marketers, airlines, and publishers"]; and
3. Others, such as [provide illustrative examples, such as "non-profit
organizations"].
We may also disclose nonpublic personal information about you to nonaffiliated third parties as
permitted by law.
A-5 - Service provider/joint marketing exception
A licensee may use one of these clauses, as applicable, to meet the requirements of Section 7A
(5) related to the exception for service providers and joint marketers in Section 14. If a licensee
discloses nonpublic personal information under this exception, the licensee shall describe the
categories of nonpublic personal information the licensee discloses and the categories of third
parties with which the licensee has contracted.
Sample Clause A-5, Alternative 1:
We may disclose the following information to companies that perform marketing services on our
behalf or to other financial institutions with which we have joint marketing agreements:
1. Information we receive from you on applications or other forms, such as [provide
illustrative examples, such as "your name, address, social security number, assets,
income, and beneficiaries"];
2. Information about your transactions with us, our affiliates or others, such as
[provide illustrative examples, such as "your policy coverage, premium, and
payment history"]; and
3. Information we receive from a consumer reporting agency, such as [provide
illustrative examples, such as "your creditworthiness and credit history"].
Sample Clause A-5, Alternative 2:
We may disclose all of the information we collect, as described [describe location in the notice,
such as "above" or "below"] to companies that perform marketing services on our behalf or to
other financial institutions with whom we have joint marketing agreements.
A-6 - Explanation of opt out right (institutions that disclose outside of the exceptions)
A licensee may use this clause, as applicable, to meet the requirement of Section 7A(6) to
provide an explanation of the consumer's right to opt out of the disclosure of nonpublic personal
information to nonaffiliated third parties, including the method(s) by which the consumer may
exercise that right. The licensee may use this clause if the licensee discloses nonpublic personal
information other than as permitted by the exceptions in Sections 14, 15 and 16.
Sample Clause A-6:
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 disclosures permitted by law). If you wish to opt out of disclosures to
nonaffiliated third parties, you may [describe a reasonable means of opting out, such as "call the
following toll free number": (insert number)].
A-7 - Confidentiality and security (all institutions)
A licensee may use this clause, as applicable, to meet the requirement of Section 7A(8) to
describe its policies and practices with respect to protecting the confidentiality and security of
nonpublic personal information.
Sample Clause A-7:
We restrict access to nonpublic personal information about you to [provide an appropriate
description, 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.