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22 <br /> <br />Authority For Access <br /> <br />This shall be considered authorization for the following named individuals to have access to the contents held in the account of: <br /> <br />Client Name:___________________________________________________________ Client Account No. __________________ <br /> <br />Department ________________________________ Sub Department _______________________________________________ <br /> <br />Client Address: _______________________________________City: _________________State: ____ Zip Code: _____________ <br /> <br />at Starpoint Global Services. These same individuals shall be considered having authority to order any and all disposition of the contents of this <br />account by personal access, telephone, facsimile, email or written request until further written notice. <br /> <br /> <br />ADD THE FOLLOWING: <br /> <br />__________________________ ___________________ __________________________ <br />(Printed First Name) (Printed Last Name) (Optional Password, 8 characters) (Signature) <br /> <br />__________________________ ___________________ __________________________ <br />(Printed First Name) (Printed Last Name) (Optional Password, 8 characters) (Signature) <br /> <br />__________________________ ___________________ __________________________ <br />(Printed First Name) (Printed Last Name) (Optional Password, 8 characters) (Signature) <br /> <br />__________________________ ___________________ __________________________ <br />(Printed First Name) (Printed Last Name) (Optional Password, 8 characters) (Signature) <br /> <br />__________________________ ___________________ __________________________ <br />(Printed First Name) (Printed Last Name) (Optional Password, 8 characters) (Signature) <br /> <br />__________________________ ___________________ __________________________ <br />(Printed First Name) (Printed Last Name) (Optional Password, 8 characters) (Signature) <br /> <br />__________________________ ___________________ __________________________ <br />(Printed First Name) (Printed Last Name) (Optional Password, 8 characters) (Signature) <br /> <br /> <br />VOID THE FOLLOWING: <br /> <br />_________________________________________________ _____________________________________________________ <br />(Printed First and Last Name) (Printed First and Last Name) <br /> <br />_________________________________________________ _____________________________________________________ <br />(Printed First and Last Name) (Printed First and Last Name <br /> <br />_________________________________________________ _____________________________________________________ <br />(Printed First and Last Name) (Printed First and Last Name <br /> <br />_________________________________________________ _____________________________________________________ <br />(Printed First and Last Name) (Printed First and Last Name <br /> <br /> <br />Authorized By: <br /> <br />____________________ _________________________ ______________ ____________ <br />(Print Name) (Signature) (Title) (Date) <br /> <br />This document is confidential and contains the names of those individuals who are authorized to access any and all records stored at Starpoint Global Services. This information is intended <br />only for the use of those individuals. Do not copy or distribute. To maintain security of your records please notify us immediately of any and all changes using this form. Changes become <br />effective 24 hours after receipt of Original Copy. Fax and photocopies cannot be accepted. <br />THIS AUTHORIZATION MUST BE SIGNED BY AN OFFICER OR AUTHORIZED MANAGER OF THE COMPANY <br /> <br />DocuSign Envelope ID: 2A625151-A0A5-4550-AF52-91CBC3DDBC3C