Please print out this form and fax the completed version to Laura Rush at 703-356-6179 or mail to Laura Rush at CommTek Communications Corporation, 8330 Boone Blvd., Suite 600, Vienna, VA 22182. The persons signing this application certify that all of the information contained in this application and any attachments is true and correct. Exact name of business DBA if applicable Customer # Year Established Division if applicable Mailing Address Street City, State, Zip Location of Corporate Offices (if different than mailing address) Street Address City, State, Zip Phone Fax Legal Status (circle one): Sole Proprietorship Partnership Corporation Limited Liability Company Please provide name(s) and social security number(s) of owner(s)/principal(s) of the Applicant: President/CEO Controller/CFO State of Incorporation or Registration of Partnership CREDIT REFERENCES (Please include three creditors with which you have an open account). Reference #1: Name Address City/State/Zip Phone Fax Contact Reference #2: Name Address City/State/Zip Phone Fax Contact Reference #3: Name Address City/State/Zip Phone Fax Contact BANK REFERENCE Name of Bank and Branch Phone Contact Account #(s) I authorize the bank to release information on the above account(s). This is an application for credit. CommTek Communications Corporation reserves the right to extend, deny or terminate credit based on the terms of this agreement. By signing this agreement, applicant agrees to: 1) Allow CommTek Communications Corporation credit personnel to contact trade, bank references and outside reporting agencies for the purpose of establishing credit. 2) Provide financial statements, if necessary, to establish credit. 3) Pay invoices within 30 days or be assessed 1 1/2% per month finance charge. 4) Be responsible for any attorney fees or collection costs incurred as a result of delinquency. 5) CommTek Communications Corporation may request updated credit information for the purpose of maintaining credit terms with an account. Signature Date Print name of signatory Please print out this form and fax the completed version to Laura Rush at 703-356-6179 or mail to CommTek Communications Corporation, 8330 Boone Blvd., Suite 600, Vienna, VA 22182 ©1998 CommTek Communications Corporation - All Rights Reserved.