By selecting "Accept" you are confirming that you are the Insured or the duly authorized representative of the Insured for the purposes of making an online payment. You are also agreeing to receive, when available, electronic notifications or statements showing the upcoming automatic withdrawals to the valid email address that you have provided.
You agree and consent that the use of a key pad, mouse or other device to select an item, button, icon or similar act/action ("e-sign") while using any electronic service we offer; or in accessing or making any transactions regarding any agreement, acknowledgement, consent, terms, disclosures or conditions, constitutes your signature, acceptance, and agreement as if actually signed by you in writing. You agree and understand that your e-signature executed in conjunction with the electronic submission of each document shall be legally binding and such transaction shall be considered authorized by you. Any e-signed document shall be deemed to have been "signed" and will constitute an "original" document when printed and used in the normal course of business. You may withdraw your consent to e-sign documents by contacting our office at the mailing address or e-mail address provided below. If you withdraw your consent or decline the option to e-sign a document, we will not be able to complete your paperwork until we receive the signed documentation.
You have the right to receive a paper copy of each document that you have signed electronically. You can obtain a paper copy of any electronic communication by printing it yourself or by requesting that we mail you a paper copy, which will be provided at no charge. (Please include your name, email address, mailing address, daytime phone number and the document you wish to receive) If you wish to receive a paper copy, please send a request to email@example.com.
AGENTS: If you received a policyholder's authorization to make a premium payment online, please sign into www.cnacentral.com to make the premium payment.