Appendix C to Part 222 - Model Forms for Opt-Out Notices
12:3.0.1.1.3.11.3.1.3 : Appendix C
Appendix C to Part 222 - Model Forms for Opt-Out Notices
a. Although use of the model forms is not required, use of the
model forms in this appendix (as applicable) complies with the
requirement in section 624 of the Act for clear, conspicuous, and
concise notices.
b. Certain changes may be made to the language or format of the
model forms without losing the protection from liability afforded
by use of the model forms. These changes may not be so extensive as
to affect the substance, clarity, or meaningful sequence of the
language in the model forms. Persons making such extensive
revisions will lose the safe harbor that this appendix provides.
Acceptable changes include, for example:
1. Rearranging the order of the references to “your income,”
“your account history,” and “your credit score.”
2. Substituting other types of information for “income,”
“account history,” or “credit score” for accuracy, such as “payment
history,” “credit history,” “payoff status,” or “claims
history.”
3. Substituting a clearer and more accurate description of the
affiliates providing or covered by the notice for phrases such as
“the [ABC] group of companies,” including without limitation a
statement that the entity providing the notice recently purchased
the consumer's account.
4. Substituting other types of affiliates covered by the notice
for “credit card,” “insurance,” or “securities” affiliates.
5. Omitting items that are not accurate or applicable. For
example, if a person does not limit the duration of the opt-out
period, the notice may omit information about the renewal
notice.
6. Adding a statement informing consumers how much time they
have to opt out before shared eligibility information may be used
to make solicitations to them.
7. Adding a statement that the consumer may exercise the right
to opt out at any time.
8. Adding the following statement, if accurate: “If you
previously opted out, you do not need to do so again.”
9. Providing a place on the form for the consumer to fill in
identifying information, such as his or her name and address.
10. Adding disclosures regarding the treatment of opt-outs by
joint consumers to comply with § 222.23(a)(2) of this part.
C-1 Model Form for Initial Opt-out Notice (Single-Affiliate Notice)
C-2 Model Form for Initial Opt-out Notice (Joint Notice) C-3 Model
Form for Renewal Notice (Single-Affiliate Notice) C-4 Model Form
for Renewal Notice (Joint Notice) C-5 Model Form for Voluntary “No
Marketing” Notice C-6 Model Form for Voluntary “No Marketing”
Notice C-1 - Model Form for Initial Opt-out Notice
(Single-Affiliate Notice) - [Your Choice To Limit
Marketing]/[Marketing Opt-out]
• [Name of Affiliate] is providing this notice.
• [Optional: Federal law gives you the right to limit some but
not all marketing from our affiliates. Federal law also requires us
to give you this notice to tell you about your choice to limit
marketing from our affiliates.]
• You may limit our affiliates in the [ABC] group of companies,
such as our [credit card, insurance, and securities] affiliates,
from marketing their products or services to you based on your
personal information that we collect and share with them. This
information includes your [income], your [account history with us],
and your [credit score].
• Your choice to limit marketing offers from our affiliates will
apply [until you tell us to change your choice]/[for x years from
when you tell us your choice]/[for at least 5 years from when you
tell us your choice]. [Include if the opt-out period expires.] Once
that period expires, you will receive a renewal notice that will
allow you to continue to limit marketing offers from our affiliates
for [another x years]/[at least another 5 years].
• [Include, if applicable, in a subsequent notice, including an
annual notice, for consumers who may have previously opted out.] If
you have already made a choice to limit marketing offers from our
affiliates, you do not need to act again until you receive the
renewal notice.
To limit marketing offers, contact us [include all that
apply]:
• By telephone: 1-877-###-####
• On the Web: www. - .com
• By mail: Check the box and complete the form below, and send
the form to:
[Company name] [Company address]
_Do not allow your affiliates to use my personal information to
market to me.
C-2 - Model Form for Initial Opt-out Notice (Joint Notice) - [Your
Choice To Limit Marketing]/[Marketing Opt-out]
• The [ABC group of companies] is providing this notice.
• [Optional: Federal law gives you the right to limit some but
not all marketing from the [ABC] companies. Federal law also
requires us to give you this notice to tell you about your choice
to limit marketing from the [ABC] companies.]
• You may limit the [ABC] companies, such as the [ABC credit
card, insurance, and securities] affiliates, from marketing their
products or services to you based on your personal information that
they receive from other [ABC] companies. This information includes
your [income], your [account history], and your [credit score].
• Your choice to limit marketing offers from the [ABC] companies
will apply [until you tell us to change your choice]/[for x years
from when you tell us your choice]/[for at least 5 years from when
you tell us your choice]. [Include if the opt-out period expires.]
Once that period expires, you will receive a renewal notice that
will allow you to continue to limit marketing offers from the [ABC]
companies for [another x years]/[at least another 5 years].
• [Include, if applicable, in a subsequent notice, including an
annual notice, for consumers who may have previously opted out.] If
you have already made a choice to limit marketing offers from the
[ABC] companies, you do not need to act again until you receive the
renewal notice.
To limit marketing offers, contact us [include all that
apply]:
• By telephone: 1-877-###-####
• On the Web: www. - .com
• By mail: Check the box and complete the form below, and send
the form to:
[Company name] [Company address]
_Do not allow any company [in the ABC group of companies] to use
my personal information to market to me.
C-3 - Model Form for Renewal Notice (Single-Affiliate Notice) -
[Renewing Your Choice To Limit Marketing]/[Renewing Your Marketing
Opt-Out]
• [Name of Affiliate] is providing this notice.
• [Optional: Federal law gives you the right to limit some but
not all marketing from our affiliates. Federal law also requires us
to give you this notice to tell you about your choice to limit
marketing from our affiliates.]
• You previously chose to limit our affiliates in the [ABC]
group of companies, such as our [credit card, insurance, and
securities] affiliates, from marketing their products or services
to you based on your personal information that we share with them.
This information includes your [income], your [account history with
us], and your [credit score].
• Your choice has expired or is about to expire.
To renew your choice to limit marketing for [x] more years,
contact us [include all that apply]:
• By telephone: 1-877-###-####
• On the Web: www. - .com
• By mail: Check the box and complete the form below, and send
the form to:
[Company name] [Company address] _Renew my choice to limit
marketing for [x] more years. C-4 - Model Form for Renewal Notice
(Joint Notice) - [Renewing Your Choice To Limit
Marketing]/[Renewing Your Marketing Opt-Out]
• The [ABC group of companies] is providing this notice.
• [Optional: Federal law gives you the right to limit some but
not all marketing from the [ABC] companies. Federal law also
requires us to give you this notice to tell you about your choice
to limit marketing from the [ABC] companies.]
• You previously chose to limit the [ABC] companies, such as the
[ABC credit card, insurance, and securities] affiliates, from
marketing their products or services to you based on your personal
information that they receive from other ABC companies. This
information includes your [income], your [account history], and
your [credit score].
• Your choice has expired or is about to expire.
To renew your choice to limit marketing for [x] more years,
contact us [include all that apply]:
• By telephone: 1-877-###-####
• On the Web: www. - .com
• By mail: Check the box and complete the form below, and send
the form to:
[Company name] [Company address] _Renew my choice to limit
marketing for [x] more years. C-5 - Model Form for Voluntary “No
Marketing” Notice Your Choice To Stop Marketing
• [Name of Affiliate] is providing this notice.
• You may choose to stop all marketing from us and our
affiliates.
• [Your choice to stop marketing from us and our affiliates will
apply until you tell us to change your choice.]
To stop all marketing, contact us [include all that apply]:
• By telephone: 1-877-###-####
• On the Web: www. - .com
• By mail: Chec>k the box and complete the form below, and
send the form to:
[Company name] [Company address] _Do not market to me. [Reg. V, 72
FR 62962, Nov. 7, 2007, as amended at 74 FR 22642, May 14, 2009]