Client Privacy AgreementClient Privacy Agreement • November 17th, 2016
I/we warrant and confirm that the information provided to Dominion Lending Centres Powerhouse Mortgages (“you”) by me/us in the mortgage application form is true and correct, and I/we understand that it is being used to determine my/our credit responsibility. You are authorized to obtain and further information you may apply and each such source is hereby authorized to provide you with such information. You are further authorized to disclose to any other lender, credit bureau or insurer or insurance agent such personal and financial information, as you consider appropriate. And I/we agree to indemnify you against and save you harmless from any and all claims in damages or otherwise arising from such disclosure on your part.
Client Privacy AgreementClient Privacy Agreement • April 27th, 2004
Pursuant to the Health Insurance Portability and Accountability Act (“HIPAA”) of 1996, and its implementing regulation, the Standards for Privacy of Individually Identifiable Health Information, 65 Fed. Reg. 82,462 et seq. (Dec. 28, 2000), the final rule, (Aug. 14, 2002), and future amendments to the implementing Regulation (hereinafter the “HIPAA Privacy Rule”), as well as other applicable federal and state privacy and confidentiality rules, Covenant Insurance Group, Inc. (“Agent”) and (“Client”) (Jointly “the Parties”) wish to enter into an Agreement that addresses the requirements of the HIPAA Privacy Rule.
