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ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES I acknowledge that I was provided a copy of the Notice of Privacy Practices and that I have read (or had the opportunity to read if I so chose)

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1. Individuals who are required to disclose their personal information for a specific purpose, such as applying for a job, filling out an application, or enrolling in a program.
2. Companies or organizations that need to collect personal information from individuals, such as for customer registration or compliance purposes.
3. Government agencies or institutions that gather personal information from citizens for administrative or legal purposes.

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smbprn00000001 privacyformdocx is a privacy form document used for reporting sensitive information.

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