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					                      Electronic Delivery of Statements Consent Form


In order to receive the customer statements electronically, please complete the following consent
form and return the form to: New Accounts Department, One Peregrine Way, Cedar Falls, IA
50613 or send to NewAccts@PFGBest.com. If you have any questions please contact the New
Accounts Department at 800.553.1711.

PFGBEST will institute a statement fee for those customers who do not choose not receive your
statements electronically.

         Acknowledgment to Receive Daily and Monthly Statements Electronically

                   FILL ALL INFORMATION OUT IN ITS ENTIRETY


       Account Name           ____________________________________

       Account Number         ____________________________________

       E-Mail Address         ____________________________________

       Telephone Number       ____________________________________

Customer agrees, acknowledges, and elects to receive the daily account activity and monthly
account statement for Customer’s account electronically. By making this election, Customer
acknowledges that Customer will not be receiving those statements by postal service. Customer
may elect to change this process at any time by contacting PFGBEST at 319.553.2100.


______________________________________              __________
Customer Signature                                  Date

______________________________________
Print Name

______________________________________              __________
Customer Signature                                  Date

______________________________________
Print Name


      Please submit completed form to PFGBEST – New Accounts Department via fax to
                  319.277.0880 or via e-mail to newaccounts@pfgbest.com.

				
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