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employee sign it. NI payments hereunder shall be payable only to us at our exEcuUve offices unLeSS we direct you
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TITLE
DATE
PB ACCOUNT REP NAME
PB ACC~ ~*-u BY
EMPLOYEE # 7 P 9 -~ ~-P
TITLE DATE
EXECUTIVE OFFICE: 27 WATERVIEW DR * SHELTON, CT 06484-4361 · EQUIPMENT VENDOR: PITNEY BOWES, INC. · FOR SALES AND SERV1CE CALL 1-800-322-8000
WHITE COPY PBCC · PINK COPY PITNEY BOWES INC. · YELLOW COPY CUSTOMER
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