OPT-OUT REQUEST MAIL IN FORM
Please Print Clearly
NAME:________________________________________________________
 
ADDRESS:____________________________________________________
 
CITY:_________________________STATE:_______________ZIP:_______
 
PHONE NUMBER:(_______)_____________________________
 
VEHICLE IDENTIFICATION NUMBER (VIN #) _________________________
 

Return Request To:

 

Milton Ruben Superstore
3514 Washington Rd  

Augusta, GA 30907

 

I understand this Request may cause me to no longer receive promotional or exclusive offer for many product or services we provide. I direct the dealership not to share my nonpublic personal information as set forth below {please check appropriate box(es)}:
 
__ I direct the dealership not to share nonpublic personal information about me with non-affiliated third parties, except as permitted by law.
__ I direct the dealership not to share nonpublic personal information about me among its affiliated companies, except as permitted by law.
 
Please note: If you finance or lease another vehicle from our dealership after you submit this Opt Out request, you will receive another copy of our Privacy Policy and Opt Out form. If you wish to Opt Out in connection with your new purchase or lease, you will need to submit another Opt Out request at that time.