SHOWTURF CREDIT CARD AUTHORIZATION FORM Company name: L— Sir Nombre de copania Address: Direccion Phone number: ( ri-o) (6:43,-(3S-69" Telefono Fax number: (W)9 -1 -5 2--52S Telefono de fax Col co Scro i-tor saTi Credit card: VA-MEX VISA MASTERCARD Tarjeta de credito Credit card number: Numero de tarjeta Expiration date: Dia de expiracion Security code: Codigo de segurida Billing address: E_ R-I 'SF ThTisa tT Direccion donde reciben los pagos N Lir/pi-2a authorize Showturf to Charge $ 373.OO to my credit card account. Print name of card holder: LA) Nombre en la tarjeta oi pc -7009 Signature of card holder: firma 0 ti thcZ. Please send signed and completed forms to 561-732-9972 or [email protected] EFTA01221281