Consent to Electronic DeliveryFont Size:AAAConsent to Electronic Delivery Customer agrees before service to electronic delivery of service visit informationName First Last Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date* MM slash DD slash YYYY Explanation of Terms*Documentation of service, service records, service reports, inspection reports, monitoring records and reports are maintained electronically. These documents and information will be collectively known as "Electronic Communications." You are acknowledging that you are able to use and are able to retain Electronic Communications by printing and/or downloading and saving this Agreement and any other agreements, Electronic Communications, documents, or records that are signed using your E-Signature. You accept Electronic Communications provided via email and/or via the customer web portal as reasonable and proper notice for the purpose of fulfilling any and all rules and regulations, and agree that such Electronic Communications fully satisfy any requirement that communications be provided to you in writing or in a form that you may keep. Definitions • Electronic means technology having electrical, digital, magnetic, wireless, optical, electromagnetic, or similar capabilities. • Electronic Signature means an electronic symbol or process attached to, or logically associated with, a record and used by a person with the intent to sign the record.Consent to Electronic Delivery* I agreeCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.