Epstein Secrets

Ft" u punt: Larite Business Name 4) 65:5 U - FOR MARITAL PROPERTY STATES ONLY O Married O Not Married O Legally Separated Name and Address of Spouse ACCOUNT RECORD CHANGES O Close Acct O Add Soc. Sec. No. O Cards Returned O Cards Nat Returned O Reopen Account O Remove Reissue Block O Add Tel

se Finance Charge of O Reverse Late Charge Fee of O Reverse Over Limit fce of K Reverse Insurance Fee of $ $ O Reverse Current Membership Fee El Waive Membership Fee Permanently O Reverse Replacement Card Fee $ O Reverse Convenience Fee O Reverse NSF Fee K Reverse Insurance Premium Fee S O Reverse Returned

Fiequest .,rear; 1:2. Business Name V es LI- FOR MARITAL PROPERTY STATES ONLY O Married O Not Married O Legally Separated Name and Address of Spouse ACCOUNT RECORD CHANGES O Close Acct O Add Soc. Sec. No. _ - ____• _- O Cards Returned O Cards Not Returned O Reopen Account O Remove Reissue Blo

rse Finance Charge of 10 Reverse Late Charge Fee of K Reverse Over Limit fee of O Reverse Insurance Fee of O Reverse Current Membership Fee El Waive Membership Fee Permanently O Reverse Replacement Card Fee O Reverse Convenience Fee O Reverse NSF Fee K Reverse Insurance Premium Fee O Reverse Returned Check

tion Name: Authorized Signature: Colonial Bank Print . Name: Jeffrey Decmond 3.11.11.1qa 02,01) For Marital Property States Only O &tarried Spouse's Name Street Address City, State, ZIP 0 Not Married O Legally Separated Card Issuance 0 Order New Card for Must mark below to indicate the ty

Reverse Finance Charge of O Reverse Late Charge Fee of O Reverse Over Limit fee of El Reverse Insurance Fee of O Reverse Current Membership Fee El Waive Membership Fee Permanently O Reverse Replacement Card Fee El Reverse Convenience Fee O Reverse NSF Fce O Reverse Insurance Premium Fee O Reverse Returned Chec