ions: -0 Federal Express astir address if different from Cardholder billing address: City State ZIP Code Visa Purchasing Card Options nancial Institution Name: Co ( uthorized Signature: 8Y-Yes. N-No. Ill)efault to Company Set-up (if yes. indicate % of lima available for cash) 3.107 MIDSbc (11/00) 73- 4-4 Age