12 C.F.R. § 1022 app C to Part 1022
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 § 1022.23(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-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: Check the box and complete the form below, and send the form to:[Company name]
[Company address]
-Do not market to me.
12 C.F.R. 1022 app C to Part 1022