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se call Customer Care. • Please print dearly In blue or black ink only In the boxes provided. Street Address City, State Zip Code Area Code and Horne Phone Area Code and 1Vork Phone Email Website: americanexpress.com Mobile Site: amexmobile.com Customer Care & Billing Inquiries P.O. BOX 981

OSTCO Account Ending p. 7x13 Amount 09/18/14 US LACROSSE 0202 BALTIMORE MD Description CONTRIBUTIONS/DONAT $25.00 09/18/14 ZAPPOS.COM NV SHOES $693.85 09/19/14 AMAZON.COM AMZN.COWBILL WA MERCHANDISE $9.93 09/19/14 COSTCO WHSE 40324 00NOFtWALK a $39.36 09/19/14 COSTCO WHSE 40324

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ROAD, SW3 GOODS/SERVICES SIGN & TRAVEL*/ EXTENDED PAYMENT OPTION 214.58 282.15 1612) 324.41 3(100 -Towle Stairg 60.36 03/27/07 EMMA HOPES SHOES, LONDON W11 GOODS/SERVICES SIGN & TRAVEL*/ EXTENDED PAYMENT OPTION 03/27/07 DAYLESFORD ORGANIC, LONDON SW1W GOODS/SERVICES SIGN & TRAVEL* / EXT

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81023 NEW YORK NY FAMILY CLOTHING 280.25 04/21/04 SEARLE NEW YORK NY WOMEN'S READY-TO-WEAR 350.86 04/22/04 GALO SHOE IMPORTS NEW YORK NY SHOES 128.18 04/23/04 SHOE INN PALM BEACH FL 5999/38 SHOES/ACC 385.84 04/23/04 NEIMAN MARCUS PALM BEACH FL NUTMEG GNGER 50.00 BASIL MANDRN 50.