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Opt-Out Form

Royal Neighbors of America respects your right to opt out of its sharing of your information with non-affiliated third parties for marketing purposes.

Please understand that we will still mail insurance or annuity policy information to you as long as you have an in-force policy with Royal Neighbors of America. Royal Neighbors of America may still share your name, address and telephone number, Social Security number [for tax-reporting and identification purposes], the existence of your products, services or benefits, and data about you as needed by our fraternal operations.

Should you still choose to opt out of the sharing of your information for certain marketing activities please indicate your choices below:


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I would like my name removed from your internal marketing lists. (Royal Neighbors of America’s regular service mailings may still contain marketing materials.)


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Do not share data about me with non-affiliated third parties with which Royal Neighbors of America has a joint marketing agreement. (Royal Neighbors may still provide data to third parties for the policy servicing and administration or about your transactions for our everyday business purposes.)



This opt out choice will be effective until you choose to opt back in. We will not ask you to opt back in until at least 12 months has passed from the date you sign below.



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Signature


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Date


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Printed Name (First, Middle Initial & Last) and Address



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Certificate Number


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Email Address



Please return this form to:

Royal Neighbors of America
230 16th St.
Rock Island, IL 61201