Credit Card Authorization for G.O. Auction 11-46-214/264 Online Auction 2/24/11 Please type or clearly print information in form below. Bidder’s User Name Email Address Name as it appears on credit card Billing Address of credit card City / State / Zip Phone Number Fax Number Credit Card Type (check one) □ MC □ Visa □ AMEX □ Discover Credit Card Number Expiration Date (MM/YY) Card Verification Code Amount of Charge $2500.00 Signature: Date: Signature above authorizes URS to charge the required deposit amount indicated to my credit card. This places a “hold” of the required deposit amount of $2500 on my credit card. I understand that if I am a successful bidder, this amount will be charged to my credit card as the initial deposit with any remaining monies owed also charged to this credit card. I further acknowledge that if I am not a successful bidder, the funds authorization will be voided by URS; however, a funds hold in the deposit amount may be placed on my account by my banking institution lasting up to 30 days. Send completed authorization form, along with Bid Deposit Form, to Lydia Quental Fax: 703-330-4162 Email: firstname.lastname@example.org THE BID DEPOSIT FORM MUST ACCOMPANY THIS CREDIT CARD AUTHORIZATION IN ORDER TO PROCESS YOUR AUCTION REGISTRATION. FAILURE TO PROVIDE BOTH FORMS MAY RESULT IN A DELAY IN PROCESSING YOUR REGISTRATION OR PREVENT YOU FROM BIDDING IN THE AUCTION.