TOLIC Affiliate Marketing Opt Out Form

TOLIC Affiliate Marketing Opt-Out Form

Trans-Oceanic Life Insurance Company (TOLIC) is providing this notice and opt-out form.

TOLIC does not sell, rent, lease, or otherwise disclose non-public personal information (NPI) of its customers for purposes unrelated to TOLIC products and services.

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 TOLIC group of companies from marketing their products or services to you based on your personal information that we collect and share with them. This information may include your income, your account history with us, and other personal information you may have provided to us during your transaction history with TOLIC. To see a current list of our affiliates visit www.tolic.com

If you previously told us of your choice, you do not have to fill out another form, since your choicei s already on file with us. Your choice to limit marketing offers from our affiliate(s) will remain until you notify us that you would like to change your choice.

To limit marketing offers, please check the box and complete the form below.

Do not allow TOLIC affiliates to use my personal information to market to me.

To ensure proper identification and accurate processing of this request, please complete the following and date the form:

Policy Number

Date of Birth (mm/dd/yyyy)

Full Name

First NameLast Name

MI

Address

City

State

Zip Code

Today's Date (mm/dd/yyyy)

PLEASE DO NOT SEND ANY OTHER DOCUMENTS WITH THIS FORM (e.g., claims, premium payments)

Email: customerservice@tolic.com

Post Mail: TOLIC #121 O'Neill St., Hato Rey, PR 00918

P.O. Box 363467, San Juan, PR 00936-3467

Fax: 787-620-2713

Rev. 04/23