Privacy Statement and Declaration: By completing this form, you will have provided Assurein with your personal information that relates to you or other individuals (such as yourdependents). Assurein will only use the information for lawful business purposes and is committed to protecting the integrity, confidentiality, access and use of personal information that we collect from you now and in the course of our business. You have the right to access and correct personal data that may be incorrect or incomplete.
