EFTA00186537

<table><tr><td>233-107 MIDSbc (11/00)</td></tr></table>

# COMMERCIAL CARD PRODUCTS – INDIVIDUAL ACCOUNT INFORMATION

## SECTION I - AUTHORIZED USERS

| Name | Credit Line | Cash Advance Capability "D" or % of Limit | Pin Y/N | Div. ID | Div. Name | Reporting Unit (Optional) Dept. ID | Dept. Name | General Ledger # | Taxable Y/N* | MEA Y/N* |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| Andrea N. Hirsch | 3000 | "D" or % of Limit | Pin Y/N | Div. ID | Div. Name | Reporting Unit (Optional) Dept. ID | Dept. Name | General Ledger # | Taxable Y/N* | MEA Y/N* |
| Mother's Maiden Name (Optional) | Social Security Number (Optional) | Home telephone # (Optional) | City | State | ZIP Code | Account Number (Metavantage Use) | | | | |
| Cardholder billing address | | | City | State | ZIP Code | | | | | | |
| Special Handling Instructions: □ Federal Express | | | City | State | ZIP Code | | | | | |
| Plastic address if different from Cardholder billing address: | | | City | State | ZIP Code | | | | | |

## Name

- Mother's Maiden Name (Optional)
- Social Security Number (Optional)
- Home telephone # (Optional)

### Account Number (Metavantage Use)

- Cardholder billing address:
  - Credit Line: Cash Advance Capability "D" or % of Limit Pin Y/N
  - Div. ID: Div. Name
  - Reporting Unit (Optional) Dept. ID: Dept. Name
  - General Ledger #: Taxable Y/N*
  - MEA Y/N*

- Special Handling Instructions: □ Federal Express
- Plastic address if different from Cardholder billing address:

### Name

- Mother's Maiden Name (Optional)
- Social Security Number (Optional)
- Home telephone # (Optional)

### Account Number (Metavantage Use)

- Cardholder billing address:
  - Credit Line: Cash Advance Capability "D" or % of Limit Pin Y/N
  - Div. ID: Div. Name
  - Reporting Unit (Optional) Dept. ID: Dept. Name
  - General Ledger #: Taxable Y/N*
  - MEA Y/N*

- Special Handling Instructions: □ Federal Express
- Plastic address if different from Cardholder billing address:

* Please Purchase Card Options
Financial Institution Name: COLONIAL BANK
Authorized Signature: 211-107 MIDDLE (1100)

EFTA00186538

# COMMERCIAL CARD PRODUCTS – INDIVIDUAL ACCOUNT INFORMATION

## SECTION 1 – AUTHORIZED USERS

| Company Name: | MGS LLC | Company Number: | Corporate Account: |
| :--- | :--- | :--- | :--- |
| Name | Alfredo Rodriguez | Credit Line 2,500 | 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) | 453-49-9253 | Home telephone # (Optional) | Account Number (Metavante Use) | | | |
| Cardholder billing address | 457 Madison Ave, Fourth Floor | City New York | State N.Y. | ZIP Code 10022 | | | |
| Special Handling Instructions: | Federal Express | | City | State | ZIP Code | | |
| Plastic address if different from Cardholder billing address: | | | | | | | |

| Name | Joseph Rueda | Credit Line 1,000 | 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 (Metavante Use) | | | |

| Name | Luciano Fontcilla | Credit Line 1,000 | 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 (Metavante Use) | | | |

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

| Name | Luciano Fontcilla | Credit Line 1,000 | 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 (Metavante Use) | | | |

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

* 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: Colonial Bank
Authorized Signature: Jeff Desmond
Date: 9/23/04



233-107 MIDSbc (11/00)