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side for a description of when adSdional Finance Charges are not assessed on Features. Check here If address or telephone number has changed. Pease note changes on reverse side. 0000371565781431005 001959396001959396 25 rI EFTA01705037 DUPLICATE COPY Prepared For Mom* Number JEFFREY E EPS

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option offered by the Commercial Car Rental Company. This coverage is in excess to your other sources of insurance. INSURANCE tar Rental Loss and Damage Insurance is underwritten by AMEX Assurance Company, Administrative Office, Green Bay, WI. Coverage is determined by the terms, conditions, and exclusions of

ncy, we will choose a conversion rate that is acceptable to us to convert your payment into US dollars, unless a particular rate is required by law. Pease do not send post-dated checks. They will be depesited ton receipt. Our acceptance of any payment marked with a restrictive legend will not operate a

the Rental Company. This coverage is in excess to your other sources of insurance and applies for the first 30 days of rental. Car Rental Loss and Damage Insurance is underwritten by AMEX Assurance Company, Administrative Office, Green Bay, WI. Coverage Is determined by the terms, conditions, and exclusions of

providers service all markets. In some instances k may take more than one billing cycle before initial paid amounts are posted to tho Card account. Pease remember to cancel these payments with your service provider if you dose your Card account, and advise your service provider if your Card account nu

n bank accounts, credit cards, investments, or insurance. The form number is replaced with the following: 'CRLDI-DOC-CEN 11/05' Car Rental Loss and Damage Insurance is underwritten by AMEX Assurance Company, Administrative Office, Green Bay‘ Wl. Coverage is determined by the terms, conditions, and exclusions of