---
tags: DDA, Priority 5, Chris
---
# Reg E Notice Opt-In Confirmation- rgewrd
# notice_ddargewrd

@{
var throwError=true;
var jsonHelper = Model.GetJsonHelper(Model.Sequence.Data, throwError);

}

#### Confirmation of Consent for Standard Overdraft Services (ATM and Everyday Debit Card Transactions)

**Date:** @jsonHelper.GetValue("technical.corDateR")<br/>

**Account Number:** @jsonHelper.MaskValue(@jsonHelper.GetValue("account.accountNumber"),'*',0,13)<br/>

<br/>

This confirms your consent on (#F_490#)@? to our authorization and payment of overdrafts on ATM and everyday debit card transactions on the account listed above.<br/>

<br/>

**To REVOKE this agreement** ***at any time****, check the box and sign below. Make sure your name and account number are legible on this form and bring the form to any office of the bank or mail it to:
@jsonHelper.GetValue("BankName?")<br/>
@jsonHelper.GetValue("BranchMailAddress?")<br/>
@jsonHelper.GetValue("BrannchCity?")<br/> @jsonHelper.GetValue("BranchState?")<br/>
@jsonHelper.GetValue("BranchZip?")<br/>
<br/>
Or you may call (@jsonHelper.GetValue("BranchPhoneNumber?")) during business hours.<br/>

<br/>

If you should revoke this consent to authorize and pay overdrafts on ATM and everyday debit card transactions, the bank will discontinue its payment of such overdrafts as soon as practicable after receiving notice of your revocation. Any joint owner of the account may revoke the agreement.<br/>

- [ ] I revoke the earlier consent for the payment of overdrafts on ATM and everyday debit card transactions on the account identified above.<br/>

<br/>

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Account #: \______________________ &nbsp;&nbsp; Name: \_________________________________________________<br/><br/>

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Date: \____________________________ &nbsp;&nbsp; Signature: \_____________________________________________