Talent Release Form 

I hereby grant Independent Bank Corporation and its subsidiaries and affiliates permission to use my likeness, voice, picture, and name for publicity purposes, including print, radio, website, social media, and/or television advertisements/commercials to be broadcast anywhere in the state of Michigan and the world, without additional compensation; and to edit such material on film or videotape for these purposes.

By typing my name and information below, I hereby attest that I have read, and agree to the above statements.