O'Connor & Company LLC

ELECTRONIC MEDIA

Delivery of monthly/daily account statements consent form

Customer may choose to receive account statements by Internet access. If you request a hard copy of any customer statements an additional charge may be assessed.

Account statements/confirms are made available via the Internet by filling out the electronic form located at https://oasis.eoconnor.com/signup.html or by contacting our Client Services Department directly at 312 604-8084. You may then choose to discontinue the mailing of your statements by completing this form and sending to O'Connor & Company LLC at the address listed below. Account statements/confirms are available on-line for the five (5) most recent trading days only. Statements/confirms older than five (5) days are only available in hard copy by contacting your account representative. Customer acknowledges that customer's statement is deemed received when made available to customer by O'Connor regardless of whether customer actually accessed the statement.

This consent shall remain in effect until revoked by customer in writing and received by O'Connor at 175 West Jackson Boulevard, Suite 400, Chicago, IL 60604.

The undersigned, by signing this consent form, hereby confirm that the undersigned is authorized to enter into this agreement.

Authorized Signature(s)
Print Name(s)
Date
Account Number(s)
Telephone
Email Address
Please print and return signed form to the address listed above, or send via telefacsimilie to (312) 604-8119.