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inancial institution to deduct the amount of my monthly wireless phone bill from the account associated with the enclosed check and remit payment to Cingular Wireless. This authority will be effective until I notify Cingular Wireless to terminate it. I agree that I may be assessed a service charge (up to $20) or l
dress Only. Please print address clearly and check the box on the reverse sale. Please contact Customer Care to change the Account Name and transfer Financial Responsibilrly. New Billing Address City State Zip Home Phone ( Work Phone ( It your billing address is NOT your Tax Address. please enter the Tax Ad
inancial institution to deduct the amount of my monthly wireless phone bill from the account associated with the enclosed check and remit payment to Cingular Wireless. This authority will be effective until I notify Cingular Wireless to terminate it. I agree that I may be assessed a service charge (up to $20) or l
dress Only. Please print address clearly and check the box on the reverse side. Please contact Customer Care to change the Account Name and transfer Financial Responsibilrly. New Billing Address City State Zip Home Phone ( Work Phone ( II your billing address is NOT your Tax Address. please enter the Tax Ad
inancial institution to deduct the amount of my monthly wireless phone bill from the account associated with the enclosed check and remit payment to Cingular Wireless. This authority will be effective until I notify Cingular Wireless to terminate it. I agree that I may be assessed a service charge (up to $20) or l
ddress Only. Please pnnt address clearly and check the box on the reverse side. Please contact Customer Care to change the Account Name and transfer Financial Responsibilrly. New Billing Address City State Zip Home Phone ( Work Phone ( tl your billing address is NOT your Tax Address. please enter the Tax Ad
inancial institution to deduct the amount of my monthly wireless phone bill from the account associated with the enclosed check and remit payment to Cingular Wireless. This authority will be effective until I notify Cingular Wireless to terminate it. I agree that I may be assessed a service charge (up to $20) or I
ddress Only. Please pant address clearly and check the box on the reverse side. Please contact Customer Care to change the Account Name and transfer Financial Responsibilrly. New Billing Address City State Zip Home Phone ( ) Work Phone ( 11 your billing address is NOT your Tax Address. please enter the Tax Ad
Entities connected to both Cingular Wireless and Financial Responsibilrly

Eric Holder
PERSONAnaheim Hills
LOCATIONCingular Wireless Processing
ORGANIZATIONDELRAY BCH FL
ORGANIZATIONWAITNG
ORGANIZATIONMARTIN GOLICK
PERSONPEMBROKPNS FL
ORGANIZATIONReese
PERSON