Common use of AGREEMENT SIGNATURE Clause in Contracts

AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS INTERNATIONAL (NZ), INC. The Entity named above (“You”)requests that American Express International (NZ) Inc provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express International (NZ) Inc to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above Entity. Title First Name Last Name Position Company Name (As per registered Company Name) Telephone Number Fax Number – – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Email Address (Mandatory) In order to comply with the Anti-Money Laundering and Countering Financing of Terrorism Act 2009 American Express International (NZ) Inc is required to gather identification information (including residential address and date of birth) on those individuals that are authorised to act on behalf of the customer, this includes the Authorised Signatory, Programme Administrator and the Decision Maker. We will not be able to process your application without this information. Decision Maker’s Address14 City Postcode Date of birth D D / M M / Y Y Company Decision Maker’s Signature14 ✘ Date D D / M M / Y Y Y Y

AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS INTERNATIONAL (NZ), INC. The Entity named above (“You”)requests You”) requests that American Express International (NZ) Inc provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express International (NZ) Inc to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above Entity. Title First Name Last Name Position Company Name (maximum 40 characters) (As per registered Company Name) Telephone Number Fax Number – – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Email Address (Mandatory) In order I would like to comply with the Anti-Money Laundering enrol for BTA Reports YES NO Spend Comparison Report DHTML Airline Usage Report DHTML Trip Requisition Analysis DHTML Traveller Analysis Report DHTML Customer Reference Analysis DHTML Top 10 Air Routings Report DHTML Do you have an existing @ Work User ID ? YES NO If Yes, please provide your User ID If No, please provide your day and Countering Financing month of Terrorism Act 2009 birth. You will be prompted to enter this as authentication when completing your online registration to American Express International (NZ) Inc is required to gather identification information (including residential address and date of birth) on those individuals that are authorised to act on behalf of the customer, this includes the Authorised Signatory, Programme Administrator and the Decision Maker@ Work. We will not be able to process your application without this information. Decision Maker’s Address14 City Postcode Date of birth D D / M M / Y Y 13(b). Additional Statement Recipient Title First Name Last Name Telephone Number Mailing Address City Postcode We need an email address to send the Company Decision Maker’s Signature14 ✘ Date D D / M M / Y Y Y Ychanges to the Terms and Conditions, servicing and marketing communications from American Express. Email Address

AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS American ExpresS INTERNATIONAL (NZ), INC. The Entity named above (“You”)requests that American Express International (NZ) Inc provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express International (NZ) Inc to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above Entity. Title First Name Last Name Position Company Name (As per registered Company Name) Telephone Number Fax Number – – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Email Address (Mandatory) In order to comply with the Anti-Money Laundering and Countering Financing of Terrorism Act 2009 American Express International (NZ) Inc is required to gather identification information (including residential address and date of birth) on those individuals that are authorised to act on behalf of the customer, this includes the Authorised Signatory, Programme Administrator and the Decision Maker. We will not be able to process your application without this information. Decision Maker’s Address14 City Postcode Date of birth D D / M M / Y Y Company Decision Maker’s Signature14 ✘ Date D D / M M / Y Y Y Y