EFTA00186581¶
STAVANTE CORPORATION¶
credit card Services¶
use indicate Commercial Card Product type:¶
- VISA
- MasterCard
- Corporate
company Name: NIS LLC¶
NIS LLC Product Type: Business¶
Company Number: Corporate Account:¶
ECTION 1 - AUTHORIZED USERS¶
| Name | Credit Line | Cash Advance Capability | Reporting Unit (Optional) |
|---|---|---|---|
| Dana Burns | 500 | ”D” or % of Limit | Pin VN |
| others Maiden Name (Optional) | Social Security Number | Hajime telephone # (Optional) | Account Number 1 |
| 劫holder billing address | 457 Madison Ave 4th FC | City New York | State NY |
| special Handling Instruction: Federal Express | Attn: Ribard Kabo | City | State |
static 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 | Home telephone # (Optional) | Account Number |
| Cardholder billing address | City | State |
Special Handling Instruction: Federal Express Plastic address if different from Cardholder billing address: City | State |¶
| Name | Credit Line | Cash Advance Capability | Reporting Unit (Optional) |
|---|---|---|---|
| Molbers Maiden Name (Optional) | Social Security Number | Home telephone # (Optional) | Account Number |
| Cardholder billing address | City | State |
Special Handling Instruction: Federal Express Plastic address if different from Cardholder billing address: City | State |¶
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Visa Purchasing Card Options*
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Visa Purchasing Card Options*
Financial Institution Name: [Signature]¶
Agent # [Date]¶