Privacy Policy

Title V of the Gramm-Leach-Bliley Act (GLBA) generally prohibits any financial institution, directly or through its affiliates, from sharing nonpublic 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 ad 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 Historic Square Agency.

The GLBA further requires that we inform you that you have the 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.

At Historic Square Agency, we are committed to providing you the best service while earning your trust and protecting the privacy of your information. We understand and respect the fact that you may wish to keep your personal information confidential.

The following is out policy on how we handle your information:

1. Collection of your information

We collect nonpublic personal financial information about you from the following sources:

• Information from applications. This is information you give us on applications and other forms, by phone or online (if applicable). This information includes your name, address, telephone number, drivers license number, Social Security number, date of birth, length of employment, gender, marital status, prior insurance information, status of home ownership, length of residency, vehicle description, miles driven and vehicle use/driving history that we receive from you on applications or other forms.
  
• Information about transactions. This is information about your trusted transactions with us and our affiliates. It includes your insurance coverage premiums and selections, your payment and claims history and information necessary for billing and payment. Other information used to investigate and settle insurance claims, such as witness statements and police reports, may be included as well.
  
• Information we receive from a consumer reporting agency. This information is generally used to confirm or supplement application information. We disclose consumer report information only as necessary to quote or service your insurance policy and as permitted by law. By obtaining a quote, you consent to our sharing of this information with companies and their affiliates for underwriting purposes.

2. Disclosure Policy

We may disclose the following kinds of nonpublic personal information about you:

• Information we receive from you on applications or other forms, such as "your name, address, Social Security number, assets, income and beneficiaries".
  
• Information about your transactions with us, our affiliates or others, such as "your policy coverage, premiums and payment history".
  
• Information we receive from a consumer reporting agency, such as "your creditworthiness and credit history".

3. Nonaffiliated third parties to whom disclosure may be made

a) Disclosures to nonaffiliated third parties

We may disclose nonpublic personal financial information about you to the following types of third parties:

• financial service providers, such as "other brokers for the direct purpose of placing insurance coverage for you".
  
• we may also disclose nonpublic personal financial 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 federal and state regulations implementing that 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:

• call us at: (814) 835-3743 or toll-free at: 1-800-984-4472.
  
• fill out Item 7 on the next page and mail it back to us at: P.O. Box 8267, Erie, PA 16505-8267.

4. Confidentiality and security

We restrict access to nonpublic financial information about you to "our 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 and state regulations to guard your nonpublic personal financial information.

5. Dispute resolution

Any controversy or claim arising out of or relating to our privacy policy, or 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.

6. Reservation of the right to disclose information in unforeseen circumstances

In connection with the potential sale or transfer of its interests, Historic Square Agency and its affiliates [if any] 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 Historic Square 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.

7. Customer acknowledgement and signature

By signing my name below, I am indicating that I have read the privacy policy of Historic Square Agency and that I understand its terms. No promises or representations have been made to me to induce me to sign this form.