| CREDIT CARD ACCOUNT MAINTENANCE
Account Record, Card, PIN |
| Acct#
Name: Shannon Parciv2.
Business Name: | For Marital Property Status Only |
| Account Record Changes | |
| Close Account | |
| Cards Returned | Married Not Married Legally Separate |
| Be-Open Account | Spouse's Name |
| Add Soc. Sec. #: | Street Address |
| Add Telephone # | City, State, ZIP |
| Business From: | Card Insurance |
| Name Change From: | Card Insurance |
| Address Change to City, State, ZIP | Order New Card for Must mark below to indicate the type of card ordered |
| Add Cardholder | Send Card: |
| Order Card | Normal Delivery - 7 to 10 days |
| Delete Cardholder | Express Delivery - 2 days ($10.00 charge) |
| Add User Card | Saturday Delivery ($10.00) |
| Delete Authorized User | Faxcard - 1 day ($20.00 charge) |
| Add Credit Rating | Saturday Delivery ($10.00) |
| Add Type Code | Charge: Cardholder Financial Institution Address to Mail Card: |
| Add Automatic Payment Detection TR&R | Name Street Address City, ST, ZIP |
| Checking Acc# | Charge Cardholder Replacement Card Fee of $ |
| Minimum payment | PIN Insurance |
| Delete automatic Payment Deduction | Order PIN Reminder PIN Federal Express - 3 days ($10.00 charge) |
| Add E-mail Address | Charge: Cardholder Financial Institution Send PIN to Alternate Address Below |
| Add Mother's Maiden Name | Name Street Address City, State, ZIP |
| Add Secondary CH SS# | Balance/Payment Transfers |
| Add Secondary CH DOB | Transfer balance of $ From account # To account # |
| Add Secondary CH Daytime Phone | Transfer payment of $ From account # To account # |
| Add Fax Number | Convenience Checks |
| Add Cell Phone# | Send Convenience Checks - # of books |
| Add Pager Number | Name Street Address City, State, ZIP |
| Privacy Option | |
| Insurance | |
| Add insurance | *Using insurance, attach a signed copy of the insurance application |
| Free Text Messages/Miscellaneous Instructions | |
| | |
| Financial Institution Name: Colonial Bank | Date: 8/6/03 |
| Authorized Signature: | Bank # Agent # |
| Print | Telephone: |
| Name: Jeffrey Deamand | Ext. |