Paperless Statement Agreement Form

Contents

This product is designed to be an agreement between a financial institution and a customer which allows the customer to receive paperless statements in an electronic format for the accounts held at the financial institution in lieu of receiving them in a printed paper format by postal mail service. This product includes the following provisions:

Customer Information

General Disclosure

Scope of Service

Method of Service

Revoking Consent to Service

System Requirements

Right to Obtain Paper Copy

Written Communications

Indemnity and Liability

Exclusion of Warranties

Headings

Waiver

Assignment

Entire Agreement

Termination and Change in Terms

Governing Law

Authorized Signatures

Bank Use Only

This form template (approximately 3 pages in Arial Font Size 8 text) is available to purchase from Bankpolicies.com in Microsoft® Word format for a flat fee of $25.00, and you can receive your order via e-mail attachment or on CD-ROM for large volume orders.

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Placing an Order

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• The name of your organization.

• A contact name and title.

• Your mailing and billing address.

• Your telephone and fax numbers.

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NOTE: $25.00 Minimum Order. Click here for important news regarding payment terms and our return policy. Orders placed by international or non-financial institution clients must be pre-paid via credit card by visiting the Banker Store of BankersOnline.com where our products are also offered. Specifically, this product is located here.

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