EFTA00186530¶
M&I Data Services¶
EFD Card Services¶
Please indicate Commercial Card Product Type:¶
- VISA
- MasterCard
- Corporate
Company Name: NES LLC¶
SECTION 1 - AUTHORIZED USERS¶
| Name | Credit Line | Cash Advance Capability † | Reporting Unit (Optional) Dept ID | Dept Name |
|---|---|---|---|---|
| Mothers Malden Name (Optional) | Social Security Number | Home telephone # (Optional) | Account Number (EFD Use) |
| Cardholder billing address | City | State | ZIP Code |
|---|---|---|---|
| Special Handling Instructions | Forest Express | ||
| Plastic address if different from Cardholder billing address: | City | State | ZIP Code |
| Name | Credit Line | Cash Advance Capability † | Reporting Unit (Optional) Dept ID | Dept Name |
|---|---|---|---|---|
| Mother’s Malden Name (Optional) | Social Security Number | 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 † | Reporting Unit (Optional) Dept ID | Dept Name |
|---|---|---|---|---|
| Mother’s Malden Name (Optional) | Social Security Number | 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 Option¶
† Y=Yes, N=No, D=Default to Company Set-up (If yes, indicate % of limit available for cash)¶
Agent # Bank #¶
Financial Institution Name:¶
Authorized Signature:¶