E-sign Disclosure
Disclosure: For the Consumer’s convenience, this is a copy of the E-sign Act Disclosures included in the TCPA Disclosure located in the form you signed and submitted to NFDM in order that NFDM will contact you about NFDM services. Please be advised that the "Agree & Send" button reference in this Copy is our template action button, and that the action button you pressed when submitting the form may contained a different acceptance language. Being that this is a copy of the E-Sign Act Disclosures, there is no action to be taken by you. You may print and save this form for your records.
Consent to Use of Electronic Records and Signatures
You have the opportunity to complete and sign documents, as well as receive notices and other documents related to your Submission Form and interaction with NFDM, in electronic rather than paper form. To agree to these uses of electronic documents and signatures, and to sign this document with the same effect as physically signing your name, click the "Agree & Send" button on the bottom of the form on the page after reviewing the information below.
In order to sign, complete and receive documents electronically you will need the following:
- • A personal e-mail address
- • A computer or other device with standard e-mail software
- • Current version of Chrome, Firefox, Edge or Safari
- • A connection to the internet
- • A printer if you want to print paper copies
Alternatively, you may choose to contact NFDM, through a phone call, and you may submit any request for services through paper versions of the documents.
By clicking "Agree & Send" on the bottom of the form on the page after reviewing the information herein, you consent to electronically sign, complete and receive documents relating to your application for information and interaction with NFDM, during both this session and any future sessions relating to this process. Additionally, you consent to electronically receive: communications relating to your application and interaction with NFDM, including requests for additional information; notices of actions taken required by law; and notices of your rights under applicable laws. Your consent applies to documents completed, signed or provided via this website, as well as to documents transmitted via email.
If your contact information changes, please update your information with NFDM, by contacting NFDM as provided below. Further, you have the right to withdraw your consent at any time by contact NFDM. You may update your information or withdraw your consent by: calling NFDM, at 1-800-352-8984 by e-mailing at [email protected], or by writing to: 13291 Icot Blvd, Suite 706, Clearwater, FL 33760
If you withdraw consent, you will no longer have the ability to sign documents electronically and to receive disclosures and other documents electronically. Your withdrawal of consent is prospective only and will become effective after we have had a reasonable opportunity to act upon it. After withdrawing your consent, please also contact the company representative who sent you this request to make arrangements to receive paper copies of documents and communications.
After consenting, you can obtain copies of documents and communications relating to your application and interaction with NFDM, by using your browser to print paper copies or save electronic copies of documents or screens during this session and future sessions.
I understand that by typing my name where indicated in the form, providing my email and phone number, and then clicking on "Agree & Send", You consent to the use of electronic records and signatures in the manner described above, and the electronic storage of such documents.
