E-SIGN CONSENT DISCLOSURE
E-SIGN CONSENT DISCLOSURE
Federal law requires you receive certain disclosures and information about the products, services or
accounts you may receive or access in connection with your relationship with us (“Required
Information.”) With your consent we can deliver Required Information to you by a) displaying or
delivering the Required Information electronically; and/or b) requesting that you print or download the
Required Information and retain it for your records.
This notice contains important information before you consent to electronic delivery of Required
Information. Your consent also permits the general use of electronic records and electronic signatures in
connection with the Required Information.
After you have read this E-sign Disclosures and Consent, if you agree to receive Required Information from
us electronically, and if you agree to the general use of electronic records and electronic signatures in
connection with our relationship, please “SIGN” below and return to:
IPN, LLC doing business as Paybotic
1800 S. Australian Ave. Ste 400
West Palm, Beach FL 33409
Statement of electronic disclosures:
If you consent to electronic disclosures, that consent applies to all Required Information we give you or
receive from you in connection with our relationship and the associated notices, disclosures, and other
documents.
You agree to print out or download Required Information when we advise you to do so and keep it for your
records. If you are unable to print or download any Required Information, you may call us and request
paper copies. If you need to update your e-mail address or other contact information with us, you may do
so by calling us and requesting necessary updates.
Your consent does not mean that we must provide the Required Information electronically. We may at our
option deliver Required Information on paper. We may also require that certain communications from you
be delivered to us on paper at a specified address.
Withdrawing Consent
You have the right to withdraw electronic consent. However, any documents you signed electronically
before you withdrew your consent will be considered legally valid and enforceable. Any electronic
documents or disclosures may be obtained in paper form and delivered by mail. The procedure to withdraw
the electronic consent can be accomplished by choosing and clicking on the “Opt Out” tab. You may, or
may not, incur additional charges by Opting Out of the electronic consent, or for receiving paper copies of
documents. Please refer to our fee schedule for our current fees related to these matters. This fee schedule
may change from time to time; you will be notified of any such change.
Hardware and Software Requirements.In order to use electronic signatures and to receive and save any document or communication electronically,
you must have:
● A computer, mobile device, or other electronic device with internet access; and
● A secure internet browser with 128 – bit encryption; and
● A program that reads and displays PDF files such as Adobe Acrobat Reader; and
● An active email address.
To print and save your document or communication in electronic form using your computer, you will need:
● A Printer (to print paper copies); and
● A hard drive or other storage device (to download and save electronic copies).
To print and save your document or communication in electronic form using your mobile or electronic
device, you will need:
● A printer capable of printing the screen shots on your mobile or electronic device (to print paper
copies); and
● An electronic device capable of taking a screen shot that can be printed (to save electronic copies).
Changes to Hardware and /or Software Requirements.
You will be notified of any changes to the hardware and/or software requirements that may create a material
risk that you will not be able to receive, view, print or save a document or communication.
[Continued on Following Page]I have read the information about the use of electronic records, disclosures, notices, and e-mail, and
consent to the use of electronic records for the delivery of Required Information in connection with
our relationship. I will be able to view this information using my computer and software. I have an
account with an internet service provider, and I am able to send e-mail and receive e-mail with
hyperlinks to websites and attached files. I also consent to the use of electronic records and electronic
signatures in place of written documents and handwritten signatures.
By:
Name:
Title: