HomeMy WebLinkAboutDocusign_CertificateCertificate Of Completion
Envelope Id: 19F0E6A8CDDF40DFA65CE5D24477F1F6 Status: Completed
Subject: Please DocuSign: FormWsigsCrissman.pdf
Source Envelope:
Document Pages: 3 Signatures: 6 Envelope Originator:
Certificate Pages: 5 Initials: 0 Cris Crissman
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
decrissm@ncsu.edu
IP Address: 174.193.5.40
Record Tracking
Status: Original
6/17/2020 7:18:50 PM
Holder: Cris Crissman
decrissm@ncsu.edu
Location: DocuSign
Signer Events Signature Timestamp
Dorothy Estelle Crissman
criscrissman@gmail.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 174.193.5.40
Sent: 6/17/2020 7:30:01 PM
Viewed: 6/17/2020 7:33:33 PM
Signed: 6/17/2020 7:33:52 PM
Electronic Record and Signature Disclosure:
Accepted: 6/17/2020 7:33:33 PM
ID: d262999a-9e8a-4568-b8ff-cbe747c88b63
Bonnie Lynn Crissman Marshall
bmarshall.slms@lee.k12.nc.us
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 47.133.204.229
Sent: 6/17/2020 7:33:54 PM
Viewed: 6/18/2020 10:04:27 AM
Signed: 6/18/2020 10:05:20 AM
Electronic Record and Signature Disclosure:
Accepted: 6/18/2020 10:04:27 AM
ID: 78f78534-b399-4cb5-a53d-8f5d17d6c9ad
Larkin Rufus Crissman
rcrissman@harristeeter.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 174.247.1.171
Signed using mobile
Sent: 6/18/2020 10:05:22 AM
Viewed: 6/18/2020 11:07:21 AM
Signed: 6/18/2020 11:08:56 AM
Electronic Record and Signature Disclosure:
Accepted: 6/18/2020 11:07:21 AM
ID: 319ecc49-71b2-45f5-a179-f053c34965a3
Teresa Arlene Crissman
tcrissman3@gmail.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 75.89.236.103
Sent: 6/18/2020 11:08:58 AM
Viewed: 6/18/2020 3:36:33 PM
Signed: 6/18/2020 3:37:36 PM
Electronic Record and Signature Disclosure:
Accepted: 6/18/2020 3:36:33 PM
ID: 8e94aee8-7e2f-4fac-bef9-552c2a872e6d
Signer Events Signature Timestamp
Belinda Kay Crissman Mattern
kcmattern@stetson.edu
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 174.227.13.144
Signed using mobile
Sent: 6/18/2020 3:37:39 PM
Viewed: 6/18/2020 3:49:05 PM
Signed: 6/18/2020 3:49:18 PM
Electronic Record and Signature Disclosure:
Accepted: 6/18/2020 3:49:05 PM
ID: ab6779ab-05fc-49ef-a8be-004dede529c1
Audrey Michelle Crissman
1amcrissman@gmail.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 75.89.236.103
Sent: 6/18/2020 3:49:20 PM
Viewed: 6/18/2020 3:50:18 PM
Signed: 6/18/2020 3:50:56 PM
Electronic Record and Signature Disclosure:
Accepted: 6/18/2020 3:50:18 PM
ID: 69f01db5-462b-49c3-96ec-3e9570a2414d
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 6/18/2020 3:49:20 PM
Certified Delivered Security Checked 6/18/2020 3:50:18 PM
Signing Complete Security Checked 6/18/2020 3:50:56 PM
Completed Security Checked 6/18/2020 3:50:56 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, NCSU (we, us or Company) may be required by law to provide to you certain
written notices or disclosures. Described below are the terms and conditions for providing to you
such notices and disclosures electronically through the DocuSign system. Please read the
information below carefully and thoroughly, and if you can access this information electronically
to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please
confirm your agreement by selecting the check-ER[QH[WWRµ,DJUHHWRXVHHOHFWURQLFUHFRUGVDQG
VLJQDWXUHV¶EHIRUHFOLFNLQJµ&217,18(¶ZLWKLQWKH'RFX6LJQV\VWHP
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.00 per-page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Electronic Record and Signature Disclosure created on: 6/17/2020 7:17:29 PM
Parties agreed to: Dorothy Estelle Crissman, Bonnie Lynn Crissman Marshall, Larkin Rufus Crissman, Teresa Arlene Crissman, Belinda Kay Crissman Mattern, Audrey Michelle Crissman
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact NCSU:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: decrissm@ncsu.edu
To advise NCSU of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at decrissm@ncsu.edu and in the
body of such request you must state: your previous email address, your new email address. We
do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from NCSU
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to decrissm@ncsu.edu and in the body of
such request you must state your email address, full name, mailing address, and telephone
number. We will bill you for any fees at that time, if any.
To withdraw your consent with NCSU
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an email to decrissm@ncsu.edu and in the body of such request you must state your
email, full name, mailing address, and telephone number. We do not need any other information
from you to withdraw consent.. The consequences of your withdrawing consent for online
documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https://support.docusign.com/guides/signer-guide-
signing-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please confirm that you have
read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or (ii) that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein, then select the check-ER[QH[WWRµ,DJUHHWRXVHHOHFWURQLFUHFRUGVDQGVLJQDWXUHV¶EHIRUH
FOLFNLQJµ&217,18(¶ZLWKLQWKH'RFX6LJQV\VWHP
By selecting the check-ER[QH[WWRµ,DJUHHWRXVHHOHFWURQLFUHFRUGVDQGVLJQDWXUHV¶\RXFRQILUP
that:
x You can access and read this Electronic Record and Signature Disclosure; and
x You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
x Until or unless you notify NCSU as described above, you consent to receive exclusively
through electronic means all notices, disclosures, authorizations, acknowledgements, and
other documents that are required to be provided or made available to you by NCSU
during the course of your relationship with NCSU.