EFTA00186537¶
| 233-107 MIDSbc (11/00) |
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 |
| Mothers Maiden Name (Optional) | Social Security Number (Optional) | 453-49-9253 | Home telephone # (Optional) |
| Cardholder billing address | 457 Madison Ave, Fourth Floor | City New York | State N.Y. |
| Special Handling Instructions: | Federal Express | City | |
| 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)¶