EFTA00186566

A/P Tracking Number:

Metavante Corporation Credit Card Services

<table border="1"><tr><td>Company Name</td><td>NAS, LLC</td><td>Company Number</td></tr><tr><td>Change Request For:</td><td></td><td></td></tr></table>



Corporate Account #





Individual Account #



Individual Account Name Alfredo Rodriguez



□ Address Change □ Company ___



$$\Box{\cdot} \mathrm{Individual}$$ ___



□ Name Change From: ___ .



To: ___

[ ] Add/Change Phone Number

<table border="1"><tr><td>□ Corporate Limit Increase to $</td><td>□ Corporate Limit Decrease to $</td></tr></table>

$$\Box Control Account Limit Increase to $ \_\_\_$$

$$\Box { Control Account Limit Decrease to $} $$



Individual Limit Increase to $ ___



$$\Box $$ Individual Limit Decrease to $ \_\_\_



□ Reverse Finance Charge of $ ___





□ Reverse Over Limit Fee of $ ___



$$\Box {Reverse Late Charge Fee of $}$$



Reverse Current Membership Fee





□ Reverse Insurance Fee of $ ___





□ Add Home Banking □ Delete Home Banking





□ Add Credit Rating ___





☐ Minimum Payment ☐ Previous Balance





□ Add Automatic Payment Deduction

T/R#

Checking Acct# ___



□ Order PIN





Change ATM Access-Cash Advance Only %





☐ Waive Membership Fee One Year





□ Waive Membership Fee Permanently



Charge Cardholder Replacement Card Fee of $ ___



□ Order New Card for ___



| Send Card | Normal Delivery - 7-10 days |

| :--- | :--- |



□ Fastcard $20 (next day - if received at Metavante by 12:00 p.m. CST)





□ Express Delivery - 2 days $10

□ Saturday Delivery Add $10

Address to Mail Card:





Charge Cardholder





Charge Financial Institution





□ Add Account R9 Rating □ Remove R9 Rating





□ List on Exception File





□ Zero Cards to Reissue





☐ Stop Interest ☐ Fix Payment - Date to Start Fix Payment ___.





Re-Age Account





□ Erase Past Due Status

# Times 1-30 □ ___ 31-60 □ ___ 61-90 □ ___ 91-120 □ ___ Erase All □ ___





Close Account



Free Text/Miscellaneous Instruction: ___

<table border="1"><tr><td colspan="4">Please attach additional documentation for the following options:</td></tr><tr><td>Add MCC</td><td>Add MEA</td><td>Add Level</td><td>Add Group</td></tr></table>