Consent Form for Electronic Signature and Delivery

CONSENT FORM
 FOR ELECTRONIC SIGNATURE AND DELIVERY

TRANSAMERICA LIFE INSURANCE COMPANY, TRANSAMERICA
FINANCIAL LIFE INSURANCE COMPANY, DIVERSIFIED INVESTMENT
ADVISORS, INC., AND DIVERSIFIED INVESTMENT SECURITIES
CORPORATION FOR “TA-Retirement.com”

Customer Electronic Consent and Disclosure

IMPORTANT NOTICE - PLEASE READ CAREFULLY
AND KEEP FOR FUTURE REFERENCE

The Transamerica Retirement Solutions Web Site – TA-Retirement.com – hereinafter referred to as the “Site” is owned by Transamerica Life Insurance Company (“TLIC”) and operated by its agents. Transamerica Financial Life Insurance Company, Diversified Investment Advisors, Inc. and Diversified Investment Securities Corporation (collectively referred to with TLIC as “Site Owners”, “We”, “Our” or “Us”) are authorized licensees of the Site.

1. What is the purpose of this Electronic Consent and Disclosure?

If you decide to conduct business electronically, receive and/or access documents electronically, and/or establish and access an online account with the Site Owners, containing information about your pension plan (“Plan”), individual pension plan account (“Account”) or the cases you service as a producer or TPA (“Cases”), you must provide the Site Owners with your consent. The documents and information described below may be sent to you electronically either via posting on the Site, a hyperlink contained in an e-mail sent to the e-mail address you provided to Us, or attached to an e-mail We send to you. If you click the “Agree” option below, you will be providing Site Owners, with your consent:

(a) to have certain documentation or information regarding your Plan, Account or Cases as described in this Customer Electronic Consent and Disclosure (“Consent”) delivered to you electronically;

(b) to execute via electronic means the documents that are described in this Consent; and

(c) to all of the terms and conditions set forth below in this Consent.

If you do not want to have the information described in this Consent delivered to you electronically, if you do not want to execute via electronic means the documents that are described in this Consent, or if you do not agree with all of the terms and conditions of this Consent, you should not agree to this document.

Your use and access to this Site is also subject to its Terms of Use and Privacy Policy.

2. What does this Consent cover once I sign it?

This Consent covers your agreement to all of the terms and conditions of this Consent, including your agreement to:

a) receive via electronic means the documents and information that Site Owners are required by law or regulation to provide or make available to you in writing as well as other documents (collectively, “Documents”); and

b) execute the Documents, where a signature is required, via electronic means and be bound with the same force and effect as if you had affixed your signature on paper by hand when you click “I Agree”, “I Accept” or otherwise apply your electronic signature to the Documents.

While not a complete listing, the types of Documents or other information that may be sent to you or otherwise made available to you electronically include:

• Group Annuity Contract and application
• Privacy rights notices
• Service forms
• Transactions such as transfers, loans or distributions
• Confirmations of certain transactions
• Plan and participant-level accounting information
• Investment fund information
• Plan contribution and payroll information
• Plan document information
• Commission information
• Password information
• Prospectuses and other required disclosure statements
• Confirmations of certain transactions
• You have opted to receive from this Site

• General communications concerning your Plan, Account or Case

Please note that annual or quarterly account statements will continue to be provided in paper copy format.  Even though you have provided Us with this Consent, We may, at Our option: (a) deliver Documents to you on paper; or (b) require that certain communications from you be delivered to Us on paper.

3. Can I get paper copies of the Documents?

Yes. You may obtain paper copies of any of the Documents at any time and without charge by contacting Us at the address provided below (or such other address as may be provided to you in the future). If you do not wish to receive any of these Documents electronically, contact Us at the address below.

4. Should I maintain copies of the Documents?

Yes. You agree to print or save this Consent and all 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 Us as appropriate.

5. How long will this Consent remain in effect?

This Consent shall become effective once you sign below. It will remain in effect for so long as your Plan(s), Account(s), or Case(s) remain in effect, or until you withdraw your consent (as described in the next section), whichever occurs first.

 6. What if I change my mind?

If at any time you would like to cease doing business electronically with Us, you will need to provide Us with written notice of your withdrawal of your consent to do business electronically, which will then terminate this Consent. You may withdraw consent at any time and without charge by contacting Us. Your withdrawal of consent to do business electronically and the termination of this Consent will become effective two (2) business days after Our receipt of your request for withdrawal. Thereafter, all new Documents will be provided to you on paper. However, if you withdraw such consent, any Documents received or transactions processed prior to your withdrawal of consent will be valid and binding on all parties. If you are a participant, you may contact your Plan Administrator for the necessary documentation to conduct transactions and manage your Account in a hard copy format.

7. What if my contact information changes?

You must keep Us informed of any changes to your e-mail address and all other contact information. You may inform Us of any such changes by contacting Us at the addresses provided below (or such other addresses as may be provided to you in the future). You agree to hold Us harmless with respect to any Documents or other information sent to the incorrect e-mail address due to your failure to provide Us with a current or valid e-mail address.

8. How can I contact Site Owners?

You can contact Us as follows:  

 9. Are there any hardware or software requirements to do business electronically with Us?

Yes. To access and retain the Documents sent or made available to you electronically by Us you must have access to a computer with an Internet connection. You must be able to send and receive e-mails, and be able to save the Documents to a storage device for later reference or have the computer connected to a printer so you can print out such documents. The minimum hardware and software capabilities are as follows:  

You should be sure that you can comply with these minimum requirements before you consent to do business electronically. In the event that We materially modify the scope of the business we conduct electronically, you may be asked to confirm your continued consent to do business electronically.

The Site protects its customers by using industry standard security measures like SSL protocol encryption. Public sections of the Site are not secure, but components used to transmit information are. For example, although the home page does not contain an "https" in the web address or a lock icon on the bottom of the browser window, the login component of this page is 100% secure. When you enter your Username and Password, your information is transmitted securely using SSL protocol encryption. After your Username and Password have been authenticated, you will be redirected to the secure sections of the Site.

PLEASE PRINT OR SAVE A COPY OF THIS CONSENT NOW FOR FUTURE REFERENCE.

I have CAREFULLY read this Consent and accept it voluntarily and with full knowledge and understanding of its terms and conditions. I have read this Consent using computer hardware and software that meets the minimum hardware and software requirements described above. I consent to having all Documents and other information described above provided or made available to me in electronic form by Site Owners or their agents, and to executing the Documents by electronic means and/or electronic signature. I have successfully printed or saved a copy of this Consent.