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We respect your privacy choices and how you would like us to use your personal information. You can ask us not to share your personal information with the Nationwide family of companies or business partners to market products to you. Remember, these companies offer many different types of financial products and services, so you may not want to opt out.

To opt out of sharing for marketing purposes, please enter your reference number and click "Opt Out". You may opt out at any time and your request will take effect in 30 days. We will apply the privacy choices to the name printed on your privacy statement. An opt out request from one joint customer will apply to all joint customers listed on your product. We'll follow your choice, unless you tell us that you've changed your mind.

We will not share the personal information of Vermont customers with the Nationwide family of companies or third parties for marketing purposes without your consent.

Privacy Reference Number:
Your Privacy Reference Number can be found on the bottom left of your privacy statement.
OR
Policy Holder Last Name: *
Policy Holder First Name: *
Last 4 Digits of Social Security Number: *





Securities and Investment Advisory Services offered through Nationwide Securities, LLC, P.O. Box 183137, Columbus, OH 43218, (888)753-7364. A Registered Investment Advisor. Member FINRA, SIPC. DBA Nationwide Advisory Services, Inc. in AR, FL, IL, WY. DBA Nationwide Advisory Services in MA, NY, OK. Nationwide, Nationwide Financial, the Nationwide framemark and On Your Side are service marks of Nationwide Mutual Insurance Company.
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NFW-2823AO.1 (09/12)