I/we understand that non-exempted, non-public personal information, including transaction and experience information, may be shared with a Tompkins affiliate for the purpose of the solicitation and marketing of products and services. I/we request an "opt-out" of the sharing of this information with Tompkins affiliates for this purpose.

I/we understand that by exercising this opt-out, that I/we will prohibit sharing of information for future solicitation or marketing of affiliate products or services that may offer a potential benefit to me/us.

           First Name:  *   Last Name: *

           Joint account holder (if any):

           Address:      *

           City:            *  State:  *   Zip:  *

           Day Phone:    Evening Phone:
              email:      
                                                                     * required fields

                                    My/Our relationship is presently with (check all that apply):

                                                  Tompkins Trust Company

                                                  Bank of Castile

                                                  Mahopac National Bank

                                                  Tompkins Insurance Agencies, Inc.

                                                  AM&M Financial Services, Inc