First National Bank eStatements - Withdrawal of Consent

ELECTRONIC DELIVERY OF STATEMENTS AND DISCLOSURES: WITHDRAWAL OF CONSENT
Please review the following and then click "I WITHDRAW CONSENT" at the end to indicate the withdrawal of your consent to the electronic delivery of statements and disclosures.

Withdrawing Consent to Electronic Delivery
You may withdraw your consent to the electronic delivery of statements and disclosures for any or all accounts by completing this Withdrawal of Consent form. You must provide the account number of each account for which you wish to withdraw your consent. After withdrawal of your consent, account statements and other disclosures with respect to the account will be provided in paper form. It will take us approximately fifteen (15) days to process a Withdrawal of Consent, and during this period you will continue to receive account statements and other disclosures electronically. If you withdraw your consent, the legal validity and enforceability of prior electronic statements and disclosures will not be affected.

Accounts Covered by Withdrawal of Consent
Please list below the name of account, account number, and email address of each account for which you wish to withdraw your consent to the electronic delivery of statements and disclosures.

Note: If you receive a combined statement for your accounts, once you select the lead account for Withdrawal of Consent, you agree to receive paper statements for all of the other accounts appearing on the combined statement.

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Withdrawal of Consent
By clicking on "I WITHDRAW CONSENT" below, you acknowledge and agree that for the account(s) listed above you withdraw your consent to the electronic delivery of statements and disclosures, and that for such accounts you no longer wish to receive account statements and other disclosures electronically.

Fields with (*) are required

Fields with () are required*