Authorization for Electronic Transactions

**Terms and Conditions have changed effective January 2021.

**Please review and accept the terms to continue.

Dear Policyholder or Producer:

For your convenience, you may complete certain transactions with Donegal Mutual Insurance Company and affiliated insurance companies ("Donegal") using electronic systems, such as Donegal's website portal or e-mail. Also, from time to time, when permitted by law, Donegal may make certain documents available to you for display or delivery via electronic systems, such as our website portal and e-mail.

Please note that this Consent does not mean that all insurance documents will be delivered to you electronically. When required by law or in the course of our current regular document processing, Donegal will still be delivering certain insurance documents and notices to you in paper form by non-electronic means such as U.S. Mail.

If you do not want to complete your application process electronically, or if you do not agree to review, sign, and receive documents from Donegal electronically, select the "I Decline" button below in which case your electronic transaction or delivery of electronic documents will be discontinued.

If you are signing for business purposes or on behalf of a business entity, your Consent confirms that you are authorized to conduct business or to act on behalf the business entity.

CONSENT FOR ELECTRONIC DOCUMENTS, SIGNATURES, AND TRANSACTIONS

By indicating "I ACCEPT" below, you are confirming that you understand and agree to the following:

1. I consent to the delivery of documents, including but not limited to documents evidencing transactions with Donegal and insurance documents (such as notices, disclosures, etc.) in an electronic form instead of in paper form, whenever Donegal is permitted by law and elects to do so.  I understand that, in some cases, Donegal might make these electronic documents available to me for display on its website, and/or on personal electronic devices or other electronic systems.
   
2. I consent to the use of electronic systems (for example e-mails, websites, texts, mobile apps, etc.) to conduct insurance and related transactions with Donegal when available and permitted by law.
   
3. I consent to the use of electronic documents in place of paper documents. This means that, unless and until you tell Donegal otherwise in accordance with the instructions included herein, Donegal will deliver electronically to you through electronic systems all required notices, disclosures, authorizations, acknowledgments and other documents that are required to be provided or made available to you in connection with your insurance transactions with Donegal.
   
4. I consent to the use of electronic signatures in place of handwritten signatures. I understand that Donegal will treat my electronic signature the same as my handwritten signature.
   
5. This Consent applies to this and future electronic transactions with Donegal, unless and until I withdraw this Consent.
   
6. I have the right to withdraw this Consent at any time in the future by sending written notice to Donegal, at the address listed below, that I am withdrawing my Consent; but if I do so, then I will no longer be able to receive electronic documents from Donegal or to sign documents from or with Donegal electronically. If I withdraw this Consent in the future, my withdrawal will not affect the legal effectiveness, validity or enforceability of any electronic document, signature or other transaction provided or made available to me prior to the implementation of my withdrawal of consent.
   
7. I may receive electronic documents, conduct electronic transactions and/or sign documents from or with Donegal electronically by having access to the Internet and to a compatible browser and by subscribing or joining an e-mail provider for a fee or free of charge. I must have an Internet browser which Donegal supports, a connection to the Internet, an active e-mail account, the current version of a program that accurately reads and displays PDF or other electronic files (such as Adobe Acrobat Reader) and a computer and operating system capable of supporting all of the above. I also understand that I will need access to a printer if I wish to print out and retain documents on paper or access to electronic storage if I wish to retain documents in electronic form. Donegal’s browser compatibility information can be found by navigating to: http://www.donegalgroup.com/browser-compatibility.
   
8. I may withdraw this Consent by mailing my request to:
   Donegal Insurance Group
   1195 River Road, P.O. Box 302
   Marietta, Pennsylvania 17547-0302
   ATTN: Automation Support
   
9. I may receive a paper copy of this Consent and any other document intended for delivery to me from Donegal by mailing a request and a self-addressed stamped envelope to the address listed above.
   
10. If my contact information (such as email address) changes or if I detect any error, I must immediately notify Donegal of the changes or of the error by calling Donegal at (888) 640-5840, or by mailing my notice to the address listed above.
    
11. I understand that the electronic documents and/or information that will be delivered to me may include sensitive and confidential insurance information, which could include non-public personal information. In such event, I agree to protect the documents and information from unauthorized disclosure, use or copying, and I agree to keep and store this information or documentation in a secure, tamper-proof system of records. In addition, I agree that I will not disclose this information to any party except the policyholder or others who are authorized to receive and use the information on the policyholder’s behalf or as required or permitted by applicable law.
    
12. I agree that I will use and will permit others to use the documents and/or information only as authorized by Donegal or any applicable party, or as required or permitted by applicable law.
    
13. I agree that, by signing below, I represent and warrant that I have been expressly authorized to request, receive, review and use the information and/or documents in furtherance of the authorizing party’s personal or business insurance needs.
    
14. I understand that, by selecting the button below indicating my agreement, I am confirming that: (a) if I am signing on behalf of a business entity, I am duly authorized to sign, to handle this transaction and to receive the electronic information and/or documents on behalf of the business entity; and (ii) if I am an insurance producer acting on behalf of a policyholder, I am licensed and have been appointed by Donegal, and I have been authorized by the policyholder to request, receive, review and use the information and/or documents that I am requesting through this system and process.
    

By checking the "I AGREE" box below, I hereby confirm that:

• I can access and read this electronic CONSENT FOR ELECTRONIC DOCUMENTS, SIGNATURES, AND TRANSACTIONS form;

• I have the hardware and software described above, that I am able to receive, review, print and store electronic documents, and that I have an active e-mail account;

• I can print out this form or save this form for future reference and access;

• I have read, understand and will be legally bound to the above-stated CONSENT FOR ELECTRONIC DOCUMENTS, SIGNATURES, AND TRANSACTIONS as if I had signed it with my handwritten signature.