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.

Ordering Instructions

Placing an order with Bankpolicies.com is fast and convenient. Your order will be completed within 24 hours via e-mail regardless of your method of payment.* Orders placed by international or non-financial institution clients must be pre-paid by credit card.

Invoice: Send an e-mail addressed to service@bankpolicies.com. Be sure to include:

• The name of your organization.

• A contact name and title.

• Your mailing and billing address.

• Your telephone and fax numbers.

Credit Card: Please visit the Banker Store of BankersOnline.com where our products are also offered. Specifically, this product is located here.

*Large volume orders shipped on CD-ROM via UPS two day mail at no extra charge.

Please ensure your SPAM filter is set to allow an e-mail originating from our Bankpolicies.com domain address to successfully arrive in your e-mailbox.

NOTE: $25.00 Minimum Order. Click here for important news regarding payment terms and our return policy.

Sample Request

Click here if you are interested in receiving a sample version of this product by e-mail attachment.

All prices as of 1/21/2012 and subject to change without prior notice.