Financial record · May 24, 2014

Commercial credit card application form for a cardholder, May 2014

A partially completed commercial Visa purchasing card enrollment form listing an authorized user and credit line options.Machine-written summary

EFTA00186578¶

COMMERCIAL CARD PRODUCTS – INDIVIDUAL¶

ECTION 1 - AUTHORIZED USERS¶

Name	Credit Line	Cash Advance Capability	Reporting Unit (Optional)
JANOSZ BAGUSZCIR	300D	”D” or % of Limit	Dept. ID, Dept. Name
Mothers Maiden Name (Optional)	Social Security Number	Home telephone # (Optional)	Account Number
Cardholder billing address	City	State
450 76200 AX 45 FC
Special Handling Instructions: □ Federal Express
Plastic address if different from Cardholder billing address:	City	State

Name	Credit Line	Cash Advance Capability	Reporting Unit (Optional)
Mothers Maiden Name (Optional)	Social Security Number (Optional)	Home telephone # (Optional)	Account Number
Cardholder billing address	City	State

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

Name	Credit Line	Cash Advance Capability	Reporting Unit (Optional)
Mothers Maiden Name (Optional)	Social Security Number (Optional)	Home telephone # (Optional)	Account Numb
Cardholder billing address	City	State

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

Name	Credit Line	Cash Advance Capability	Reporting Unit (Optional)
Mothers Maiden Name (Optional)	Social Security Number (Optional)	Home telephone # (Optional)	Account Numb
Cardholder billing address	City	State

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

Name	Credit Line	Cash Advance Capability	Reporting Unit (Optional)
Mothers Maiden Name (Optional)	Social Security Number (Optional)	Home telephone # (Optional)	Account Numb
Cardholder billing address	City	State

Yes, N=No, D=Default to Company Set up (if yes, indicate % of limit available for cash)
Agent # 1555
Date: 2014-05-24

EFTA00186579¶