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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />J.R. SMITH, CLERK <br />PINEAPPLE <br />PAYMENTS <br />chant Processing Application and Agreement <br />'eview the information below and sign if everything looks right If you have any questions please contact your representative <br />Setup Information <br />Sales Code Application Platform <br />ONGLF19 North <br />Business Details <br />Contact Information <br />First Name <br />Bela <br />Email <br />bnagy@ircgov.com <br />Last Name <br />Nagy <br />Phone Number <br />(772) 770-5000 <br />Business Information <br />NOTE: Failure to provide accurate information may result in a withholding of merchant funding per IRS regulations (See Part IV, <br />Section A 4 of your Program Guide for further information ) <br />Business Legal Name <br />Indian River County <br />DBA Name Tax Filing Name <br />Sandridge Golf Club Indian River County <br />Tax Filing Method Tax ID (EIN) <br />X EIN SSN <br />Type of Ownership <br />X Government Individual / Sole Proprietor Limited Liability Company <br />Non -Profit Org Partnership Private Corporation <br />Public Corporation Tax Exempt <br />Stock Exchange (Only applicable for Public Corporations) <br />NYSE or NASDAQ X Other/Not Applicable <br />Industry (MCC) <br />9399 - Government Services (Not Elsewhere Classified) <br />Industry Options <br />Quasi Cash <br />Website <br />Stock Ticker Symbol (NYSE or NASDAQ) <br />Business Description <br />Municipally owned Golf Driving Range <br />Business Start Date <br />Business Phone <br />(772) 770-5003 <br />Page 1 of 11 CardConnect LLC is a registered ISO of Wells Fargo Bank, N A Concord CA Version CardCo2305 <br />