Client Consent Form (Page 2 of 2) in pdf

Client Consent Form Page 2

Hart & Associates, PC

Your Information

Your non-public personal information is collected from various sources:

� Information received from you on, worksheets, client questionnaires, applications

and other financial documentation you provide;

� Information you provide via personal interviews, telephone conversations, faxes

and e-mails;

� Information about your transactions with the firm;

� Information received about you from consumer reporting agencies if background

or credit checks are conducted on your behalf.

Non-Disclosure

Your non-public personal information is not disclosed to any person or party, except as

required by law or to facilitate filing your tax return.

If at some point you no longer engage our firm, your non-public personal information will

not be disclosed to any person or party unless required by law.

Security

Access to your information is restricted in a variety of ways:

� Only those employees who have a need to know in order to provide products or

services to you;

� Physical security, electronic safeguards and strict procedural measures

consistent with federal standards are in place to protect your non-public personal

information

Your privacy is important. Please trust that protecting your information is equally important.

Please feel free to call at any time if you have any questions.

Client Consent Form Page 2