NEW YORK LIFE INSURANCE COMPANY NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION NYLIFE INSURANCE COMPANY OF ARIZONA

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Darleen Tucker
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1 NEW YORK LIFE INSURANCE COMPANY NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION NYLIFE INSURANCE COMPANY OF ARIZONA Customer Electronic Consent and Disclosure (the Consent ) IMPORTANT NOTICE - PLEASE READ CAREFULLY Thank you for agreeing to use New York Life s electronic application solution. This solution allows you to sign your application forms and receive important policy communications electronically. Please review the Consent below. It explains how this solution will work. For example, it addresses: what your electronic signature means; what communications you will receive and over what period of time; what hardware or software you will need to participate in the program; how you may revoke your consent; and what to do if you fail to receive your communications electronically. Once you have fully reviewed and agree to the terms of the Consent, please click the I Agree button below. What is the purpose of the Consent? You are applying for an Annuity contract from New York Life Insurance Company, New York Life Insurance and Annuity Corporation, or NYLIFE Insurance Company of Arizona ( New York Life ) and have expressed your desire to electronically sign and/or initial the Application Forms for the Annuity contract (the Annuity Policy ) and electronically receive communications related to the application for the Annuity Policy. To conduct this business electronically, you must provide New York Life and its authorized designees and agents with your consent. By clicking the I Agree button below and agreeing to 1

2 the Consent, you will be providing New York Life and its authorized designees and agents, with your consent to the following: (a) to have the Required Documents that are described in the Consent delivered to you electronically; (b) to execute via electronic means the Application Forms that are described in the Consent; and (c) to agree to all of the terms and conditions set forth below in the Consent. If you do not want to have the Required Documents delivered to you electronically, if you do not want to execute via electronic means the Application Forms, and/or if you do not agree with all of the terms and conditions of the Consent, you may not conduct business electronically with New York Life, and you must click the I Decline button below to cancel the transaction. If you do so, the application for the Annuity Policy will be taken in paper. Once I agree to the Consent, what does it cover? The Consent covers your agreement to all of the terms and conditions of the Consent, including your agreement to: 1. execute via electronic means any documents that New York Life requires to be signed in connection with the application process for this Annuity Policy (the Application Forms ); 2. be bound with the same force and effect as if you had affixed your signature on paper, by hand, when you: (a) click Sign Here and apply your electronic signature; (b) click Initial Here and apply your electronic initials or (c) otherwise apply your electronic signature or initials to the Application Forms; 3. receive via electronic means any documents, including any Application Forms, that New York Life is required to deliver and/or make available to you, in writing, in connection with the Annuity Policy (the Required Documents ). Even though you have provided New York Life with the Consent, New York Life may, at its option, deliver the Required Documents to you in paper. 2

3 All electronic signatures and electronic initials will reflect the time and date they are applied in Eastern Time, regardless of the Time Zone in which you are located. How are my electronic signature and electronic initials applied? If you agree to the Consent, you will be able to electronically sign and initial all required fields. To electronically apply you signature and initials, you will be automatically navigated to each required signature and initial field and prompted to apply your electronic signature and initials. Your electronic signature and electronic initials will not become effective until you confirm them at the end of the electronic signature process. Until that point, you may cancel the electronic application process at any time. May I obtain paper copies of the Required Documents and the Consent? Yes. You may obtain paper copies of any of the Required Documents and/or the Consent at any time and without charge by contacting your agent. Should I maintain copies of the Required Documents received by electronic means? Yes. You agree to print or save the Required Documents and to keep printed or electronic copies of them for your records. If you have any trouble with printing or saving, you should contact your agent. In what form will I receive Required Documents by electronic means? Required Documents will be provided in Portable Document Format (PDF). You agree that you must have Adobe Acrobat viewer software installed on your personal computer or mobile device in order to view these Required Documents. You agree that if you do not have the ability to access and retain PDF documents, you should not agree to the Consent. By agreeing to the Consent, you acknowledge that you can access the Required Documents on your personal computer or mobile device in PDF form. How will I receive Required Documents by electronic means? Once the application for the Annuity Policy is complete, you will receive an at the address that you provided to your agent. This will contain a link. Upon selecting the link, you will be prompted to verify your identity. Once your identity is verified, you will be able to view, download, and/or print all the Required Documents pertaining to your Annuity Policy. You will be able to access the Required Documents for 120 3

4 calendar days after you receive the . You may also always contact your agent for copies of the Required Documents. How long will the Consent remain in effect? The Consent shall become effective once you click the I Agree button below and shall remain in effect until you withdraw your consent (as described in the next section) or the Annuity Policy is issued. What if I change my mind? You may only withdraw your consent to do business electronically before the Annuity Policy is issued. If you would like to do so, you must provide your agent with a written withdrawal of your consent to do business electronically. This will terminate the Consent and your Annuity Policy application as of the date you submit a written withdrawal request. If New York Life issues the Annuity Policy before your withdrawal is recorded, and you wish to cancel this Annuity Policy thereafter, you must exercise your right to surrender the Annuity Policy according to its terms. There is no charge to withdraw your consent. What if my contact information changes? You must keep New York Life informed of any changes to your address. You may inform New York Life of any such changes by contacting your agent. Are there any hardware or software requirements to do business electronically with New York Life? Yes. To do business electronically with New York Life and to access and retain the Required Documents sent or made available to you electronically by New York Life, you must have a personal computer or mobile device with appropriate browser software, such as Microsoft Internet Explorer, Mozilla Firefox, or equivalent, and software as well as communications access to the Internet. Additionally, pop-up blockers must be turned off in order to view the Application Forms both before and after you apply and confirm your electronic signatures and initials. You must ensure that the mobile device that you are using to view or electronically sign the Application Forms allows you to access all associated content. This access may incur charges from 4

5 Internet Service Providers and telephone or cable companies. These costs are your responsibility. To view the Required Documents in the PDF, you must have Adobe Acrobat viewer software. This software is available for download, free of charge, from the Adobe Web site ( You must have the ability to save the Required Documents to a storage device for later reference or have a connection between your computer or mobile device and a printer so you can print out the Required Documents. What if I provide New York Life with an invalid Address? If you do not receive the Required Documents by electronic means because your proves to be invalid, New York Life will send you the Required Documents via U.S. Mail using the address that you provided on your Application forms. What if I don t receive Required Documents by electronic means? From time to time, you should understand that may not transmit properly, your Internet Service Provider may experience system failure, or other electronic delivery problems may arise. You agree that if you do not receive any of the Required Documents by , you will contact your agent to request the Required Documents. 5

FOR HELP WITH THE APPLICATION OR THIS LOAN PROCESS IN GENERAL, CONTACT OUR SUPPORT DEPARTMENT AT

FOR HELP WITH THE APPLICATION OR THIS LOAN PROCESS IN GENERAL, CONTACT OUR SUPPORT DEPARTMENT AT LOAN APPLICATION YOU CAN COMPLETE IT IN A PDF READER, SAVE IT AS A NEW NAME, AND EMAIL IT TO INFO@SOLUTIONFOCUSEDFINANCIAL.COM OR PRINT IT OUT, FILL IT OUT MANUALLY, AND FAX IT TO 877-702-7286. 888-706-1426.