Privacy Statement

Larry E. Gustafson, Inc. - Notice of Information Practices

Due to the enactment of the Gramm-Leach-Bliley Privacy Act passed by the U.S. Congress as well as an amendment to Arizona’s existing laws governing the privacy of personal information gathered in context of an insurance transaction we are issuing you the following notice.


Information we may obtain: The type of information we obtain depends on the type of product or service we are providing.

Personal  Information: Personal information includes identifying information, such as, your name, address, telephone number, and demographic data about you. This may include information from persons other than you or those proposed for insurance coverage, such as an attending physician statement from your attending medical practitioner.

What we do with the Information we obtain: We use the information about you to facilitate your request for insurance products or services. This information may be shared with a prospective insurance company in an effort to procure an insurance product or service without your written authorization. Personal information, including Electronic Personal Information will not be sold or shared by our office for any other purpose than to secure requested insurance products or services. It is our practice to provide only as much information as is necessary to accomplish the intended purpose.

We may also be required to provide this information to State & Federal regulatory agencies to assist in preventing or prosecuting fraud, or to alert such agencies to the possibility of Illegal conduct.

Right to the Information:  You, as a prospective insured, have a right to access the information that is collected and to make any corrections to this personal information upon request.

In the event of an Adverse Underwriting Decision:  You may request, in writing, the reason for the adverse decision.  It must be submitted within ninety business days from the post-mark date of the notice or other communication of an adverse underwriting decision.

If you would like to have access to this information, you can send a signed written request to:

Larry E. Gustafson, Inc., 1517 E Todd Drive, Tempe, AZ 85283  

Within seven business days after receiving your request, we will contact and tell you the nature and substance of the information in our files.  You will be entitled to a copy of said file.