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ance Charges. Interest shall accrue on each account as shown on the monthly statements, for each billing period in which there is a cash advance or the Previous Balance is not paid in full prior to the Closing Date of the billing ttttt num. menu.* as computed by applying the monody notedly ride sr 1.208% (ANNUAL PE

% OF OWNERSHIP TIME WITH COMPANY: OFFICE TELEPHONE NUMBER 3. BANKING & 01 HLR CREDIT CARD RELATIONSHIPS PRIMARY BANK Chase Bank OTHER BANK: Palm Beach Bank AMERICAN EXPRESS CORPORATE CARD? OYES ONO VISA BUSINESS OR CORPORATE CARD? PYFS nNo MASTERCARD BUSINESS OR CORPORATE CARD? OYES ONO BUSINESS C

nance Charges. Interest.shat aCcrue on anon account as shown on the monthly statements, for each billing period in which there is a cash advance.or the Previous Balance is not paid in lull prior to the Closing -Date of the biting statement Interest. is computed by applying the monthly periodic — rate of 1 : 28

Chase Bank OF ACCOUNT(S): Personal account of Guarantor ' OTHER ACCOUNTS OLOAN OSAVINGS ACCT °CREDIT CARD PRIMARY BANK B S H CKING ACCOUNT # Palm Beach Bank nCHECKING ACCOUNT (LOAN f13AVINGS ACCOUNT nCRFDIT CARD AMERICAN EXPRESS ACCOUNT NUMBER: DATE OPENED: BALANCE: CORPORATE CARD? nYFS nNo VISA

inance Charges. Interest shall acaue on each account as anown on the monthly statements, for each billing period in which there is a cash advance a the Previous Balance is not paid in full prior to the Closing Date of the bitting statement. Interest is computed by applying the monthly periodic - rate of 1 .28 v

1 % OF OWNERSHIP TIME WITH COMPANY: OFFICE TELEPHONE NUMBER 3. BANKING & OTHER CREDIT CARD RELATIONSHIPS PRIMARY BANK Chase Bank OTHER BANK: Palm Beach Bank AMERICAN EXPRESS CORPORATE CARD? OYES ONO VISA BUSINESS OR CORPORATE CARD? DYES ONO MASTERCARD BUSINESS OR CORPORATE CARD? DYES ONO IMISING A

ance Charges. Interest shall accrue on each account az shown on the monthly statements. for each billing period in which there is a cash advance or the Previous Balance is not paid in lull prior to the Closing Date of the bitting statement. Interest rs computed by applying the more* periodic — rate of 1.28 .1. (AN

% OF OWNERSHIP TIME WITH COMPANY: OFFICE TELEPHONE NUMBER BANKING & 01 HLR CHL.L)I I CARD RELA I :U:.SH PS PRIMARY BANK Chase Bank OTHER BANK: Palm Beach Bank AMERICAN EXPRESS CORPORATE CARD? OYES ONO VISA BUSINESS OR f:ORPORATF CARO? nyes PNO MASTERCARD BUSINESS OR CORPORATE CARD? OYES ONO IIIIIIMIM

ance Charges. interest shall accrue on each account as shown an the monthly statements. for each billing period in which there is a cash advance or the Previous Balance is not pad in full prior to the Closing Dale of the biking statement. Interest is computed by applying the monthly periodic — rare or 1 . ZS %

ITY: STATE: ZIP CODE: YEARS AT ADDRESS OWNERSHIP STATUS: TIOWN FIRENT MOTHER: POSITION WITH COMPANY: 3 PRIMARY BANK Chase Bank OTHER BANK: Palm Beach Bank AMERICAN EXPRESS CORPORATE CARD? nYES nNo VISA BUSINESS OR CORPORATE CARD? nYES nNo MASTERCARD BUSINESS OR CORPORATE CARD? OYES ONO MONTHLY MO