Farmers & Merchants State
Bank
ELECTRONIC
DELIVERY OF BANK STATEMENTS CONSENT AND AGREEMENT
Welcome to the Bank’s Online Electronic Bank Statement Delivery Service. Our goal is to provide you with an easy and convenient way to receive your periodic Bank Statements.
1. Your Consent. For the Bank to begin forwarding your Bank Statements to you electronically, we need your consent. Please review the information below prior to giving your consent. By agreeing to have your Bank Statements sent electronically, you also agree to notify the Bank by telephone (309-772-2171) of any change in your email address or any errors or complications relating to your electronic receipt or access of your Bank Statements.
· Your consent authorizes the Bank to forward to you electronically your periodic Bank Statements and any other disclosures that the Bank might send to you with your Bank Statements, such as privacy notices or other required disclosures relating to your accounts.
· If you elect to receive your Bank Statements through electronic delivery, the Bank will no longer send you your statements through the mail. If for any reason you are unable to receive your statement electronically, please contact us for assistance and/or to obtain a paper copy.
· If you wish to receive your statements both electronically and in paper form through the mail, you may contact us to do so.
· To discontinue this electronic delivery service, you may call the Bank at 309-772-2171 or email your request to the Bank at info@bushnellbank.com.
· You may contact the bank to obtain paper copies of a particular statement. For repeated requests, we reserve the right to charge a fee for each statement reproduced in paper form.
Additionally, we will be using a service called CSIeSafe to safely and securely deliver your Bank Statements. CSIeSafe will store your Bank Statements electronically for 90 days from the date of delivery. You may print or download your Bank Statements to retain copies of them. You may subscribe to CSIeSafe’s long term storage service if you wish to retain your Bank Statements online in secure electronic storage for more than 90 days. A file will be included with your Bank Statement delivery that will contain a list of all of your banking transactions. That file can easily be imported into a number of money management programs.
3. Privacy. Our privacy policy (that has been previously provided to you) will apply to this service and the policy is incorporated into and made a part of this Consent and Agreement. CSIeSafe is subject to our rules on privacy in relation to your Bank Statements. As discussed in paragraph 5 below, you must have a unique user name and password to access your Bank Statements. Your user name must be a valid email address. This email address will be used in accordance with the Bank’s privacy statement to deliver your Bank Statements to you. It will not be sold or otherwise provided to third parties.
4. Service Availability. The Bank may change, suspend or eliminate all or any aspect of this delivery service upon notice to you.
5. Security. We are providing this service through CSIeSafe because of its method of maintaining the security of confidential documents. To access your Bank Statements you will be required to adopt a user name and password. Your password must be at least eight characters and contain a mix of letters and numbers. Your user name must be a valid email address. To protect the security of your banking information, you must not disclose or share your password with any third party. Your Bank Statements will not be forwarded to you through regular email. You will be notified by email that they are available for you to access on the CSIeSafe server.
6. NO WARRANTY FOR CONTINUOUS OR UNINTERRUPTED SERVICE. BECAUSE OF THE UNPREDICTABILITY OF THE INTERNET, WE DO NOT GUARANTEE CONTINUOUS OR UNINTERRUPTED ACCESS TO YOUR BANK STATEMENTS THROUGH THE INTERNET. HOWEVER, SHOULD YOU BE UNABLE TO ACCESS YOUR STATEMENTS, YOU MAY CALL THE BANK AT 309-772-2171 AND THE BANK WILL TAKE OTHER MEASURES TO PROVIDE COPIES OF YOUR STATEMENTS TO YOU.
7. LIMIT OF LIABILITY. YOU AGREE THAT IN NO EVENT WILL WE BE LIABLE FOR LOST PROFITS OR ANY SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES ARISING OUT OF OR IN CONNECTION WITH YOUR USE OF OUR SERVICE. FURTHER YOU AGREE THAT WE WILL NOT BE LIABLE FOR ANY TECHNICAL, HARDWARE OR SOFTWARE FAILURE OF ANY KIND, ANY INTERRUPTION IN THE AVAILABILITY OF OUR SERVICE, ANY DELAY IN OPERATION OR TRANSMISSION, ANY INCOMPLETE OR GARBLED TRANSMISSION, COMPUTER VIRUS, LOSS OF DATA, OR OTHER SIMILAR LOSS.
I accept these terms and conditions and agree to receive electronic delivery of bank statements for the accounts listed below. I affirm that I have rights to these accounts and am authorized to receive these statements.
Account Number(s): _____________________ ________________________________________
Signature
_____________________ ________________________________________
Printed Name
_____________________ ________________________________________
Email Address
_____________________ ________________________________________
Date
Please print this form, complete and sign,
and mail to:
Farmers &
Merchants State Bank
Bookkeeping Dept.