EFTA00186505





## PALM BEACH NATIONAL BANK

& TRUST COMPANY

3931 RCA Blvd, Suite 3102

Palm Beach Gardens, FL 33410

Date: 11/15/01

Fax Transmission cover Sheet

To: Credit Services

(Applications and Business card maintenance)

Ann Lufft

Sender:

Re: NES LLC

You should receive 3pages(s), including this cover sheet. If you do not receive all the pages, please call .

The information contained in this message is privileged and confidential information intended for the use of the individual or entity to whom it is addressed. If the reader of this message is not the intended recipient, the agent or employee responsible to deliver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us by telephone. Please return the uncopied message to us by U.S. Mail. Thank you.

EFTA00186506

# FOR BANKCARD USE ONLY

**Account #**
Name Use 1
Code 1
Reyed by
Pac Code 0*

## MONETARY CHANGES

- Limit Increase to $ 2,000.00
- Change Corporate Account Limit to $ 1,000.00
- Reverse Finance Charge of $ 2,000.00
- Late Change Fee of $ 5,000.00
- Over Limit Fee of $ 5,000.00
- Reverse Insurance Fee of $ 5,000.00
- Current Membership Fee
- Waive Membership Fee permanently

## CARDPIN ISSUANCE

- Order New Card for $
- Change Cardholder Replacement Card Fee of $
- Send Card
- Normal Delivery - 2 days $10
- Saturday Delivery Add $10
- Change Cardholder
- Change Financial Institution
- Fastcard $20

Address to Mail Card

## RISK MANAGEMENT COLLECTIONS

- Restricted Account - RB
- Restricted ATM Access
- List on Exception File
- Zero cards to Release
- Stop Interest
- Delete Automatic Payment Detection
- Send Balance Transfer Checks #
- To:
- Cardholder Address

If adding insurance, attach a signed copy of insurance application.

## FREETEXT MESSAGES / MISCELLANEOUS INSTRUCTIONS

Date: 11-15-01
Approved By:
Financial Institution
File Number:
Agent No:
Shop Stagements

EFTA00186507

A/P Tracking Number:

# M&I Data Services
## EFD Card Services

Please indicate Commercial Card Product type:
- VISA
- MasterCard
- Business
- Corporate
- Purchasing

Company Name: NES, LLC
Company Number: Corporate Account:

### SECTION I - AUTHORIZED USERS

| Name | Credit Line | Cash Advance Capability † "D" or % of Limit Pin Y/N | Reporting Unit (Optional) Div. ID Div. Name Dept. ID Dept. Name | General Ledger # Assigned * | Taxable Y/N* | MEA Y/N* |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| Mothers Maiden Name (Optional) | Social Security Number (Optional) | Home telephone # (Optional) ( ) | Account Number (EFD Use) | | | |

Cardholder billing address
City State ZIP Code

Special Handling Instructions: □ Federal Express
Plastic address if different from Cardholder billing address:
City State ZIP Code

Name | Credit Line | Cash Advance Capability † "D" or % of Limit Pin Y/N | Reporting Unit (Optional) Div. ID Div. Name Dept. ID Dept. Name | General Ledger # Assigned * | Taxable Y/N* | MEA Y/N* |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| Mothers Maiden Name (Optional) | Social Security Number (Optional) | Home telephone # (Optional) ( ) | Account Number (EFD Use) | | | |

Cardholder billing address
City State ZIP Code

Special Handling Instructions: □ Federal Express
Plastic address if different from Cardholder billing address:
City State ZIP Code

Name | Credit Line | Cash Advance Capability † "D" or % of Limit Pin Y/N | Reporting Unit (Optional) Div. ID Div. Name Dept. ID Dept. Name | General Ledger # Assigned * | Taxable Y/N* | MEA Y/N* |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| Mothers Maiden Name (Optional) | Social Security Number (Optional) | Home telephone # (Optional) ( ) | Account Number (EFD Use) | | | |

Cardholder billing address
City State ZIP Code

Special Handling Instructions: □ Federal Express
Plastic address if different from Cardholder billing address:
City State ZIP Code

* Visa Purchasing Card Options
† Y=Yes, N=No, D=Default to Company Set-up (if yes, indicate % of limit available for cash)

Financial Institution Name: PBJB Authorized Signature:
Agent # Bank #
Date: 11-15-01

233-107 MIDSbc (04/00)