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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 email@example.com.