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CONSENT TO ELECTRONIC DISCLOSURES UNDER E-SIGN ACT

CONSENT TO ELECTRONIC DISCLOSURES UNDER E-SIGN ACT



Please read this E-SIGN (Federal Electronic Signatures in Global and National Commerce Act) Consent Agreement carefully and retain a copy for your records.



CONSENT TO RECEIVE NOTICES AND DISCLOSURES ELECTRONICALLY



By agreeing to the terms set forth in this Agreement, you consent to the electronic delivery of any communication, which may include the following:  terms and conditions, notices, original disclosures, subsequent disclosures, statements, and any other documents.  By consenting to electronic delivery you also agree that National Billing Service, LLC will not be providing to you any future terms and conditions, notices, disclosures or other documents in paper form unless specifically requested.  By consenting to these terms you agree and acknowledge that National Billing Service, LLC is providing you electronic communications in connection with all transactions that are subject to the federal Electronic Signatures in Global and National Commerce Act (ESIGN Act).  



The Agreement between you and National Billing Service, LLC also intends, to its fullest extent, that the E-Sign Act applies to and validates our ability to conduct business with you electronically, regarding the delivery of all terms and conditions, notices, and disclosures, including privacy statements, Electronic Funds Transfer Disclosures, Electronic Services Agreements, loan disclosures or any other documents that may be required during the business relationship between you and National Billing Service, LLC.



In a case where the account or loan is jointly owned or jointly applied for, the consent of only one owner/applicant will be required to consent to the E-SIGN Act.  



RIGHT TO PAPER DELIVERY OF NOTICES AND DISCLOSURES



Customers have the right to request all terms and conditions, notices, disclosures and any other documents be provided in paper form.  To receive a paper copy of any documents that have been previously provided to you in electronic form, please contact National Billing Service, LLC in writing at the address listed below or call us at _620-564-3790_.   



COPIES



You may print or make a copy of the electronic documents by using the print function on your device or saving a PDF copy.  



SYSTEM REQUIREMENTS TO ACCESS AND RETAIN ELECTRONIC NOTICES AND DISCLOSURES



To receive, review, and download this Agreement and any amendments electronically, you will need the following equipment and software:



A personal computer or other device capable of accessing the internet to allow access to account information, and to receive, retain any print or store the document received;



Access to the internet;  



An internet web browser which is capable of supporting 128-bit SSL encrypted communications, which requires a minimum web browser version of Microsoft Internet Explorer version 6.0, and your system or device must have 128-bit SSL encryption software;  



Software which permits you to receive and access Portable Document Format (PDF) files, such as Adobe Acrobat Reader version 8.0 and above;



An email account with an internet service provider and email software in order to participate in our electronic communications program.  



If a change in the hardware or software requirements needed to access or retain electronic records creates a material risk in that you will not be able to access or retain subsequent electronic records, National Billing Service, LLC will provide you with a statement of the revised hardware and software requirements for access to and retention of electronic records.  At such time, you will have the right to revoke your consent to receive electronic records without imposition of any condition, consequence, or fee.



WITHDRAWAL OF CONSENT



Customers have the right to withdraw their consent to delivery of all communications in electronic form for any of their accounts, which may include:  terms and conditions, notices, disclosures and any other documents.  Withdrawal of consent will be applicable to not only a single transaction but will apply to all electronic information including terms and conditions, notices, disclosures and any other documents. To update your contact information, please contact National Billing Service, LLC at the address or telephone number listed below.  We will not impose a fee to process the withdrawal of your consent to receive electronic communications.  Any withdrawal of your consent to receive electronic communications will be effective only after we have a reasonable period of time to process your withdrawal.  



It is the customer’s responsibility to provide National Billing Service, LLC with accurate and complete contact information, including e-mail address, and any other information related to the accounts.  You can update such information by contacting National Billing Service, LLC at the address or telephone number listed below.  



Contact Information:   National Billing Service, LLC



                    105 N. Main St



                    PO Box 517



                    Ellinwood, KS 67526



                    (620)564-3790



                    webmaster@nationalbillingservice.com

Click Here for Billing Rights Summary

ELECTRONIC STATEMENT AUTHORIZATION

I/We hereby agree to accept future billing statements by electronic media as processed by National Billing, LLC or its subsidiaries.  As part of this authorization, a consent is granted under the Federal Electronics Signatures in Global and National Commerce Act. A copy of the E-Sign Act is attached, along with acknowledgement that Billing Rights Summary have been provided.
A copy of the Billing Rights Summary is available at www.nationalbillingservice.com

It is further understood that individual invoices will not be provided in the email statement.  Only a copy of the monthly statement will be provided.  It will be the customer responsibility to retain individual invoices at the time of purchase.

Please complete the following information, authorize and fax to National Billing Services at
620-564-3792 or email to webmaster@nationalbillingservice.com

For additional customer service contact National Billing Service 1-620-564-3790.


Emails will originate from National Billing, LLC  and the statement will be provided in PDF form.

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