PURPOSE OF THIS NOTICE

Title V of the Gramm-Leach-Bliley Act (GLBA) and the laws of the State of Massachusetts, generally prohibit us from sharing nonpublic personal information about you with a third party unless we provide you with this notice of our privacy policies and practices describing the type of information that we collect about you and the categories of persons or entities to whom that information may be disclosed. In compliance with the GLBA and the laws of this State, we are providing you with this document, which notifies you of the privacy policies and practices of Fabri & Rourke Insurance Agency, Inc.

The laws of this State further require that we inform you that we may not share your personal information with a non-affiliated third party for any purpose that is not specifically authorized by law unless we obtain your affirmative permission.

OUR PRIVACY POLICIES AND PRACTICES

1. Information we obtain:
A. Categories of Information Collected and Sources From Which We Obtain It:

We collect nonpublic personal information about you from the following:
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 such as a driving record; Information we receive from medical records or medical professionals;

Unless it is specifically stated otherwise in an amended Privacy Policy Notice, no additional information will be collected about you.

B. Persons From Whom Information is Collected

We may collect nonpublic personal information from individuals other than those proposed for coverage, such as from the Registry of Motor Vehicles or previous insurance carriers.

2. Information we may disclose to third parties:

In the course of our general business practices, we may disclose the information that we collect (as described above) about you or others without your permission to the following types of institutions for the reasons described:

To a third party if the disclosure will enable that party to perform a business, professional or insurance function for us; To an insurance institution, agent, or credit reporting agency in order to detect or prevent criminal activity, fraud or misrepresentation in connection with an insurance transaction; To an insurance institution, agent, or credit reporting agency for either this agency or the entity to whom we disclose the information to perform a function in connection with an insurance transaction involving you; To a medical care institution or medical professional in order to verify coverage or benefits, inform you of a medical problem of which you may not be aware, or conduct an audit that would enable us to verify treatment; To an insurance regulatory authority, law enforcement, or other governmental authority in order to protect our interests in preventing or prosecuting fraud, or if we believe that you have conducted illegal activities; To a group policyholder for the purpose of reporting claims experience or conducting an audit of our operations or services;

In addition to those circumstances listed above, and unless you tell us not to, we may disclose certain information about you to third parties whose only use of the information will be for purposes of marketing a product or service. Under no circumstances will we disclose for marketing purposes any medical information; information relating to a claim for benefit or, a civil or criminal proceeding involving you; or personal information relating to your character, personal habits, mode of living or general reputation.

3. Notification That Certain Disclosures Require Your Authorization:

As we have indicated in this Privacy Policy Notice, we collect certain personal information about you, and we may disclose that information to certain non-affiliated third parties. We are permitted by law to disclose your personal information in the circumstances described in paragraph 2 without your permission. FOR ALL OTHER DISCLOSURES, WE ARE REQUIRED TO OBTAIN YOUR AUTHORIZATION. The disclosures that first require your authorization are described in more detail on a separate authorization form that we will provide to you.

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 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 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 person 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: Glass companies, Auto rental companies, Claims adjusters and Auto Body shops.

C. 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 by sending your request in writing to Fabri & Rourke Insurance Agency, Inc., Attention President, 153 Andover Street, Suite #208 ., Danvers, MA 01923

5. Your right to access and amend your personal information:

You have the right to request access to the personal information that we record about you. Your right includes the right to know the source of the information and the identity of the persons, institutions or types of institutions to whom we have disclosed such information within 2 years prior to your request. Your right includes the right to view such information and copy it in person, or request that a copy of it be sent to you by mail (for which we may charge you a reasonable fee to cover our costs). Your right also includes the right to request corrections, amendments or deletions of any information in our possession. The procedures that you must follow to request access to or an amendment of your information are as follows:

To obtain access to your information: You should submit a request in writing to Fabri & Rourke Insurance Agency, Inc., Attention: President, 153 Andover Street, Suite #208 ., Danvers, MA 01923. The request should include your name, address, social security number, telephone number, and the recorded information to which you would like access. The request should state whether you would like access in person or a copy of the information sent to you by mail. Upon receipt of your request, we will contact you within 30 business days to arrange providing you with access in person or the copies that you have requested.

To correct, amend, or delete any of your information: You should submit a request in writing to Fabri & Rourke Insurance, Inc., Attention: President, 153 Andover Street, Suite #208 ., Danvers, MA 01923. The request should include your name, address, social security number, telephone number, the specific information in dispute, and the identity of document or record that contains the disputed information. Upon receipt of your request, we will contact you within 30 business days to notify you either that we have made the correction, amendment or deletion, or that we refuse to do so and the reasons for the refusal, which you will have an opportunity to challenge.

6. 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.

7. 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 judgment upon the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof.


---------------------------------------------------------------------------------------------------------------
FABRI & ROURKE INSURANCE AGENCY, INC. Opt Out Form

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 153 Andover Street, Suite #208 ., Danvers, MA 01923. 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 descrlbed.

______ I wish to exercise my right under the Gramm-Leach-Bliley Act to opt out of Fabri & Rourke's sharing nonpublic personal information about me to non-affiliated third parties for purposes other than those that are permitted by law.

______ I wish to exercise my right under the Fair Credit Reporting Act to opt out of Fabri & Rourke's sharing nontransactional information about me to affiliates.

Customer Signature: _____________________________________

Print Name: _____________________________________________

Date: ________________