E-SIGN ACT CONSUMER DISCLOSURE

Consent to Electronic Records

By agreeing to this disclosure, you agree to accept all applicable disclosures associated with this loan application in an electronic form including but not limited to, disclosures required by the Truth in Lending Act, Real Estate Settlement Procedures Act, and the Equal Credit Opportunity Act. Any disclosures sent with personal identifiable information will be sent password protected.

You may withdraw your consent at any time, or request paper copies of all disclosures at no cost by emailing us, visiting us at 1440 South Main St., Zumbrota, MN or by calling us at (507) 732-7555. Paper copies will be provided for certain real estate related transactions after your loan application is received.

System Requirements: To receive the disclosures by email you will need to have access to the internet using a browser that supports 128-bit encryption. You will also need Adobe Acrobat Reader version 5.0 or greater to open the attachments. You may obtain Adobe Acrobat Reader at adobe.com. You should use the functions in your browser or Adobe to save and print the disclosures. You will be notified if there are any significant changes to system requirements.

You further agree to inform Bank of Zumbrota in writing of an email address change, which may take up to 5 business days to process.



USA PATRIOT ACT

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT:

To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. This is in accordance with Section 326 of USA PATRIOT ACT signed October 26, 2001.

WHAT DOES THIS MEAN FOR YOU AS A NEW CUSTOMER?

When you open any type of account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We will ask to see your driver’s license or other identifying documents. If you are opening an account on behalf of a business entity, documents in relation to the business may also be requested.


I/We hereby consent to receive the disclosures for this loan application in an electronic form and confirm that I am able to access and print the disclosures.


I AGREE --- will continue on to the Federal Credit Application Insurance Disclosure and Personal (Consumer) Loan Application

CANCEL


If you prefer a paper copy of the application and the disclosures, please visit Bank of Zumbrota; 1440 South Main Street; Zumbrota, MN 55992.

Or call (507) 732-7555 to have them mailed to you.