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and grace periods by calling 1-800-518-8866. Change of Address UPOrteCi on front do not use Street Address City, State Sp Cede Stott Code end Horne Phone Area Coda and Walt Phone Erna (notioal] To Pay By Phone 1.800.472.9297 Customer Service 1.800.528.4800 24 hours/7 days Lost or Stolen

FL UL CHMP 1287 FUEL/MISCELLANEOUS ROC No. 6854131 09/28/06 THE MILLHOUSE JACKSONVILLE FL 41.81 35.99 FOOD AND BEVERAGE 09/29/06 BP 5135 WELLINGTON FL BP PAY AT PUMP796840745023 09/29/06 CHEVRON 0205068 JACKSONVILLE FL UL CRIAP 1287 FUEUMISCEUANEOUS ROC No. 6854610 09/29/06 HERTZ CAR

ee of 1.75% of all past due amounts will be added. Change of Address laded on trent do not VSO Strom Address Cdy, slate r, Cede /deaf/We and Horne Phone Area Code and Y/o* Phone Email (cabana° To Pay By Phone 1.800.472.9297 Customer Service 1.800327.2177 24 hours/7 days Lost or Stolen C

: Class: AA Y2 Date of Departure: 09/10 695.60 09/10/05 MINI DELI OF BIG APPNEW YORK NY MISC FOOD STORE 36.62 09/12/05 CHICK-F1L-A 101280 WELLINGTON FL FAST FOOD RESTAURANTS 15.52 Continued on next page EFTA01703754 DUPLICATE COPY Papered Fa Account Number gentry polo Page 13 of 18 JEF

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LODGING 172.22 Total of New Activity for New Charges Payments/Crects 10,652.23 0.00 New Actoltt elfsir CIMAXICX- 07/09/05 CHICK-FIL-A 901260 WELLINGTON FL FAST FOOD RESTAURANTS 9.73 46.00 07/09/05 X & R CORP INC St THOMAS VI Desolation FOOD AND BEVERAGE 07/0405 VIRGIN ISLAND ST. THOMAS VI

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Ages20 Sex: Female LOXAHATCHEE FL 33470-3628. PALM BEACH COUNTY DL 9: Regisiront(s Name Age: 41 Sex: Male DL Address: 1292 THE 121}I FAIRWAY, WELLINGTON FL 33414-5788, PALM BEACH COUNTY Name: Age: 20 Sex: Female DL Address: LOXAHATCHEE FL 33470-3628, PALM BEACH COUNTY Lion Holder Holder: CITIFIN

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TATUTES - IMAGES INCLUDE PHOTOGRAPHS AND SIGNATURES Conditional Messages: SAFE DRIVER Individual Summary Page DUD Number Class Status C VALID WELLINGTON FL 334Is All Addresses On File Date of Birth Scx Height State Of Birth F 5'03 Vermont Restrictions Endorsements Issue Date Duplicate MaDate

call Customer Care. • Please print clearly in blue of black ink only in the boxes provided. Street Address n City. State Zip Code Area Code and Horne Phone Area (ode and Work Phone Entail WebsIte:amencanexpiess com Customer Care & BIII Inquiries P.O. BOX 981535 EL PASO,TX 79998-1535 Paym

ER TO RECEIPT 01/04/18 AMKI MARKET PALM BEACH FL $43A2 561-8324201 Description GROCERIES/SUNDRIES 01/05/18 AUNTIE ANNES PRETZELS US- FL247 WELLINGTON i< $15.04 FAST FOOD RESTAURANT 01/05/18 CHICK-AL-A #01283 000000000471408 WELUNGTON FL $723 5613334242 01/06/18 HONEY BAKED HAM WEST PALM