Country. Primary Phone Number Secondary Phone Number Primary Email Address* Secondary Email Address Receive email notifications?* q Yes q No If not a U.S. Citizen, enter country of citizenship Employment Status: q Employed q Self Employed q Not Employed/Retired Employer Name Health Plan Type: q Single q Family Effective Date of Qualified Health Insurance (mm|dd|yyyy) / / Health Insurance Carrier *By providing an email address and checking the “Yes” box, the account holder represents and warrants that he/she consents and has the ability to receive the electronic delivery of all investment-related, account-related information and notices at the provided email address. Electronic delivery may include, but is not limited to, emailed copies of or internet links to documents in PDF format. Investment-related and account-related information and notices may include, but is not limited to fund prospectuses, tax notices, account statements, confirmations of statements, account access passwords, etc. Account holder’s consent will be in effect until revoked. Account holder may request no-cost written copies of any electronically delivered documents and/or may revoke his/her consent to electronic delivery by contacting Customer Service.
Appears in 23 contracts
Samples: Scope of Agreement, Scope of Agreement, Scope of Agreement
Country. Primary Phone Number Secondary Phone Number Primary Email Address* Secondary Email Address Receive email notifications?* q ❑ Yes q ❑ No If not a U.S. Citizen, enter country of citizenship Employment Status: q ❑ Employed q ❑ Self Employed q ❑ Not Employed/Retired Employer Name Health Plan Type: q ❑ Single q ❑ Family Effective Date of Qualified Health Insurance (mm|dd|yyyy) / / Health Insurance Carrier *By providing an email address and checking the “Yes” box, the account holder represents and warrants that he/she consents and has the ability to receive the electronic delivery of all investment-related, account-related information and notices at the provided email address. Electronic delivery may include, but is not limited to, emailed copies of or internet links to documents in PDF format. Investment-related and account-related information and notices may include, but is not limited to fund prospectuses, tax notices, account statements, confirmations of statements, account access passwords, etc. Account holder’s consent will be in effect until revoked. Account holder may request no-cost written copies of any electronically delivered documents and/or may revoke his/her consent to electronic delivery by contacting Customer Service.
Appears in 4 contracts
Samples: Scope of Agreement, Scope of Agreement, Scope of Agreement
