CREDIT APPLICATION DISCLOSURE AGREEMENT
I/We understand that information is given for the purpose of obtaining credit. I/We warrant that all of the information is true. We affirm that we are financially able to meet our obligations, and will remit in accordance with the invoice terms. I/We hereby authorize all of the persons or companies named in the application to release to Interstate Billing Service, Inc., or its representatives, any information with regard to my/our financial condition as may reasonably have a bearing on this application. I/We authorize Interstate Billing Service, Inc. to obtain my/our consumer credit report containing my/our personal credit history, if necessary, in accordance with the Federal Fair Credit Reporting Act, and to use this report in making decisions concerning my/our credit worthiness for a 30-day account. I/We understand a personal guaranty may be required. By submitting this application, I/We affirm we wish to be considered as a candidate for credit with Interstate Billing Service, Inc. A credit guideline may be established at our discretion. Applicant agrees to pay any collection costs incurred to collect the unpaid balance, including interest on the unpaid balance, as allowed by state law, and any reasonable attorney's fees. We agree not to assert any claims or defenses against the accounts purchased by you from any dealer including right of offset for invoices purchased by Interstate Billing Service, Inc. Receipt of payment acknowledges agreement to the terms and conditions set forth by Interstate Billing Service, Inc.

Your account has been assigned to Interstate Billing Service, Inc. Make checks payable to the vendor(s). Please mail all payments c/o Interstate Billing Service, Dept. 1265, P.O. Box 2153, Birmingham, AL 35287-1265 . Payment terms will be reflected on the monthly statement and/or invoice. If your business should sell or close, it is the applicants' responsibility to advice Interstate Billing Service, Inc. immediately.

This agreement shall be governed by and construed according to the laws of the State of Alabama. I/We submit to the jurisdiction of any Alabama State or Federal Court sitting in the Northern District of Alabama over any action arising hereunder and agrees that all claims will be brought in such Alabama State of Federal Court. I/We further waive any objection on the basis of forum non-conveniens. Nothing in the Section shall affect the right of IBS to bring any conditions set forth by Interstate Billing Service, Inc.

I/We agree to conduct transactions with Interstate Billing Service, Inc., its successors, assigns, and/or designees, by electronic means, including as appropriate through use and receipt of electronic records and electronic signatures.

Your account has been assigned to Interstate Billing Service, Inc. Make checks payable to the vendor(s). Please mail all payments c/o Interstate Billing Service, Dept 1265, P.O. Box 2153, Birmingham, AL 35287-1265. Payment terms will be reflected on the monthly statement and/or invoice. If your business should sell or close, it is the applicants' responsibility to advise Interstate Billing Service, Inc. immediately.

If Guarantor(s) are required, they individually, jointly, severally, absolutely, independently, and unconditionally guarantees the prompt payment when due of all amounts owed by the applicant named above to Interstate Billing Service, Inc. including reasonable attorney's fees. This guaranty applies to any and all debts owed to IBS.