How to Notify Us About Your
Information Sharing Preferences

You may use this form to:

  1. Direct us not to share your "non-identity and non-experience information" with corporate family members.
  2. Limit corporate family members from marketing their products or services to you using information we share with them.

Simply print the form, complete it, and mail it to us at the following address:

Vantus Bank, Attention: Retail Banking Processing, P.O. Box 897, Sioux City, Iowa 51102

It may take 4-6 weeks for your request to be effective. If you have previously communicated your information sharing preferences to us, you do not have to notify us again. We will continue to honor your previous request.

Accountholder A (Please Print)

Name _____________________________________________________________________________________________

Street Address ______________________________________________________________________________________

City _________________________________________________________ State _________ Zip Code _____________

Phone_____________________________________________________________________________________________

Soc. Security #/Tax ID # ______________________________________________________________________________

                                                                                                              (Required to Process)

Check all that apply:
Please do not share my "non-identity and non-experience information" with your corporate family members.
Please do not allow your corporate family members to market their products or services to me using information that you share with them (see Note 1 below).
I choose to "opt out" on behalf of other joint accountholders (see Note 2 below).

Signature _____________________________________________________________ Date ___________________


Accountholder B (Please Print)

Name _____________________________________________________________________________________________

Street Address ______________________________________________________________________________________

City _________________________________________________________ State _________ Zip Code _____________

Phone_____________________________________________________________________________________________

Soc. Security #/Tax ID # ______________________________________________________________________________

                                                                                                              (Required to Process)

 Please do not share my "non-identity and non-experience information" with your corporate family members.
Please do not allow your corporate family members to market their products or services to me using information that you share with them (see Note 1 below).
I choose to "opt out" on behalf of other joint accountholders (see Note 2 below).

Signature _____________________________________________________________ Date ___________________

Note 1: This limitation will not apply in certain circumstances, such as if you currently do business with one of our corporate family members or if you ask to receive information or offers from them.
Note 2: If you have a joint account, each accountholder may make a separate decision about "opting out". The "opt out" direction by one joint accountholder will apply only to that particular joint accountholder. However, a joint accountholder can "opt out" on behalf of the other joint accountholders.

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