Client: New York Strategy Physical Address: 457 Madison Ave New Yoh, NY 10022 Dab Management Inc. 3322 West Loop 366 San Angeio, TX 76904 CREDIT CARD AUTHORIZATION Please print cut this form, fill out completely, and return fax to Data Management st Company I -3Clnive-s 1-C I Credt Cam, Bing Address: Carchcider Name: L ctpFgey tEsmai Phone Number. Pleaseforward hie form to my eon represefrative proelPtly. Pooreseetative name] eireM , give Data Management Inc permission to charge the amount of S I 105420, for this purchase (includng any shipping and taxes) to the credit card below. Please keep this credit card number and aulhorlz.aticn on 'Ile for any future purchases. (Check one) Yes Please consider this single form b be authorization for at future purchases. CI No. I vAll fill out an autiodzabon form each tine I make a creditcard purchase. Please check one: VISA MASTERCARD!: AMERICAN EXPRESSO DISCOVERD Credit Card Number: Name on Credit Card: a — Signature: z y piraion Date: Q Date: 7 171x/07 TUT demand is enefiefeedialand Aga wee he eir *toted, pebtitlend to,eftseine4, fa ',Ade es Ar pert,” Ohne pie: waste perentesien of Dern moneirptete, pee. The tem: end many Mein CPI! silbfrcr to change withnot rake. EFTA00616676