CONSENT FORM FOR OVERDRAFT SERVICES

        After August 15, 2010 we will not authorize and pay overdrafts for the types of

                                              transactions unless you ask us to (see below).

              What You Need to Know about Overdrafts and Overdraft Fees

     An overdraft occurs when you do not have enough money in your account to cover a transaction, but we pay it

     anyway.  We can cover your overdrafts in two different ways.

            1.   We have standard overdraft practices that come with your account.

            2.   We also offer overdraft protection plans, such as a link to a savings account, which may be less expensive

                   than our standard practices.  To learn more, ask us about these plans.

      This notice explains your standard overdraft practices.

      What are the standard overdraft practices that come with my account?

      We do authorize and pay overdrafts for the following types of transactions:

                          *     Checks and other transactions made using your checking account number

                          *    Automatic bill payments

      We do not authorize and pay overdrafts for the following types of transactions unless you ask us to (see below):

                          *     ATM transactions

                          *     Everyday debit card transactions

      We pay overdrafts at our descretion, which means we do not guarantee that we always authorize and pay any

      type of transaction.

     What fees will I be charged if Med 5 FCU pays my overdraft?

      Under our standard overdraft practices:

                           *    We will charge you a fee up to $25.00 each time we pay an overdraft.

                           *    There is no limit on the total fees we can charge you for overdrawing your account.

      What if I want Med 5 FCU to authorize and pay overdrafts on my ATM and everyday debit card

      transaction?

      If you also want us to authorize and pay overdrafts on ATM and everyday debit card transactions, call (605) 342-

      7779,  visit med5fcu.com, or complete the form below and mail it to 625 Flormann St Rapid City, SD 57701, or

      Copy and paste the form below to the e-mail attached.

_____________________________________________________________________________________________________

     __________ I want Med 5 FCU to authorize and pay overdrafts on my ATM and everyday debit card transactions:

       Printed Name:________________________________________

       Date:________________________

       Account Number:__________________