Permission to Contact Statement

I, [Your Name], hereby grant permission to Steven Radeck Insurance and its representatives to contact me regarding insurance-related matters. This permission includes, but is not limited to, contacting me via phone calls, emails, text messages, and any other communication methods deemed appropriate.

I understand that the purpose of these communications is to provide information about insurance products and services offered by Steven Radeck Insurance. These communications may include updates, policy information, promotional offers, and other relevant content related to insurance coverage.

I acknowledge that I am providing this permission voluntarily and that I have the right to revoke this permission at any time. I can do so by notifying Steven Radeck Insurance in writing or by using the contact details provided in their communications.

By providing this permission to contact me, I agree to the terms outlined above and confirm that I am the authorized user of the contact information provided.

Contact Information:

• Name: [Your Full Name]
• Phone Number: [Your Phone Number]
• Email Address: [Your Email Address]
• Preferred Contact Method: [Phone/Email/Text]

Date: [Date of Signing]

[Your Signature] [Your Printed Name]

Note: This statement is a general template. Please ensure to customize it as needed and consult with legal professionals or appropriate representatives to ensure compliance with any relevant regulations or requirements in your jurisdiction.