Customer OPT-OUT Form

    * means required

    First Name*

    Last Name*

    Account Number (with Original Creditor)*

    Name of Original Creditor (related to the Account Number listed herein)*

    Home Address:

    Street 1*

    Street 2




    Mobile Phone*

    Home Phone

    Current Personal Email Address*

    Email Address Customer Wants to Opt out of Email Communications Concerning the Above Referenced Account*

    By clicking here, you certify that

    You are the Customer associated with the above referenced Account with the above referenced Original Creditor.

    You acknowledge that your election to opt out of future email communications concerning the above referenced Account is related only to the above referenced Account Number. Furthermore, you understand that any additional account(s) that First Financial Asset Management, Inc. or its affiliates have related to you may continue to receive email communications unless the You have previously opted out of receiving email communications related to those other accounts.

    You understand that you may elect to opt back into receiving future email communications related to the above referenced Account by contacting First Financial Asset Management, Inc at 1-866-867-1133 or by email us at [email protected]