EFTA00523729.pdf

STARK Credit Card Authorization Form I JEFFREY E. EPSTEIN ,Ca0m , hereby authorize Stark Carpet Corp. to charge my card for the amount indicated below. I understand these charges are for the payment of goods and/or services by the above referenced merchant. ,jam Account #: Invoice/Order #: QUOTE # 253970 Amount to be charged: 17,587.60 Credit Card Type: Amex It Visa O MasterCard O Credit Card #: Credit Card Expiration Date: 12/20 CVY / Security Code: 8842 Company Name: Cardholder Name: JEFFREY E. EPSTEIN Billing Address: 9 EAST 71ST STREET City: NEW YORK State: NY Zip Code: 10021 Phone #: Email addressfor CC receipt: Terms & Conditions: The afro named client and rstands and acknowledges the charges described above. The client agrees payment infull is be made when Ned in accordance with the standardpolicy ofthe issuing bank and without any disputes or stop nista on t above credit card. Please sign below agreeing to the above and ea-Milan:: Cardholder Signature: Print Name: JEFFREY E. EP EFTA00523729