![**ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES**
Purpose: This form is used to obtain acknowledgement of receipt of our Notice of Privacy Practices or document our good faith effort to obtain that acknowledgement.
**You May Refuse to Sign This Acknowledgement**
I, **JOHN SMITH**, have received a copy of this office's Notice of Privacy Practices.
Please Print Name: John Smith
Signature: [Signature]
Date: 1/7/2017
---
**AUTHORIZATION TO RELEASE INFORMATION**
Purpose: This form is used to obtain authorization to release information regarding yourself covered under the Privacy Act to people other than yourself.
I, **JOHN SMITH**, authorize the following person(s) to have access to information covered under the Privacy Practices regarding myself.
Please Print Name: Jane Smith
Relationship: Wife
---
**Ambir**
**SAFETY**
**JOHN SMITH**
123456789012345
67/17](https://pisces.bbystatic.com/image2/BestBuy_US/images/products/79966c85-b0d2-4591-8cbd-e75bf5dd86c3.jpg;maxHeight=100;maxWidth=150)
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in Home, Furniture & Office (214)- $220.17
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![The text on the image reads:
"12.3 TRADERS SERVICE STATISTICS YEAR 58m AMAJOR PLAYER - GROWTH YEARS 36m MONIFICANT spectnnal I rin neaa I i SEsUBAy courires T Feeurh nermi.om nurt S Europeon Tu growthe poripatiom I rny - E UBE I nroans m ordory underline proe I 1 I 5 figunes -M 1 efforta CoR mi ouneives. 1 - 1 pan EN redoubled voldity 6 ontend Congaia cgrodo $ E exponsion reached torgeted partners markets European 1,000 Global - award sopens hits Y growth profits website 7 into Endustr New Move milion I . - offured matues uoadonn ehops i IA .fram security forign ] moving Australion pairanl 3 dtroct & ocolportnen kocal aunsodlca added S brock 1 2 3 Courte 8 I esmark.ing p d Jna GLOBALOPPORTUNITIES I w Pesia d Or noten 3 - fussnad Infactour 2P ! Bethand rgrecentdle findingssoom ona -xpet GLOBAL . RO-AM i We i sauocue Our smo hotiom deliened e-seiom au iniee I I 1 I Enb S I ES-C220 EPSON"
The text is about statistics and growth in the trading service industry. It highlights the importance of targeted partners, markets, and the expansion of the company's reach. The text also mentions the company's recent findings and achievements, such as winning awards and reaching milestones in their growth.](https://pisces.bbystatic.com/image2/BestBuy_US/images/products/0b2b88ab-a3d2-4676-9b7a-0ccb5584239b.jpg;maxHeight=427;maxWidth=640?format=webp)
![**ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES**
Purpose: This form is used to obtain acknowledgement of receipt of our Notice of Privacy Practices or document our good faith effort to obtain that acknowledgement.
**You May Refuse to Sign This Acknowledgement**
I, **JOHN SMITH**, have received a copy of this office's Notice of Privacy Practices.
Please Print Name: John Smith
Signature: [Signature]
Date: 1/7/2017
---
**AUTHORIZATION TO RELEASE INFORMATION**
Purpose: This form is used to obtain authorization to release information regarding yourself covered under the Privacy Act to people other than yourself.
I, **JOHN SMITH**, authorize the following person(s) to have access to information covered under the Privacy Practices regarding myself.
Please Print Name: Jane Smith
Relationship: Wife
---
**Ambir**
**SAFETY**
**JOHN SMITH**
123456789012345
67/17](https://pisces.bbystatic.com/image2/BestBuy_US/images/products/79966c85-b0d2-4591-8cbd-e75bf5dd86c3.jpg;maxHeight=427;maxWidth=640?format=webp)
