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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />J.R. SMITH, CLERK <br />Business Address <br />Street Address 1 <br />Street Address 2 <br />City State <br />ZIP Country <br />United States of America <br />Business Legal Mailing Address <br />Street Address 1 <br />Street Address 2 <br />City State <br />ZIP Country <br />United States of America <br />Owner Information <br />Business Owner Information <br />Please provide the following information for each individual who owns, directly or indirectly, 25% or more of the equity interest of your <br />business <br />First Name Last Name <br />Title <br />CEO CFO COO X LLC Member Owner <br />Partner President Secretary Treasurer Vice President <br />Ownership Percentage Personal Guarantee <br />0 % Yes <br />SSN Date of Birth <br />Mobile Phone Email <br />Residence Address <br />Street Address 1 <br />Street Address 2 <br />Page 2 of I t CardConnect LLC is a registered ISO of Wells Fargo Bank N A Concord CA Version CardCo2305 <br />