Promotional ReceiverActivationandEquipmentLeaseAgreement Access Card# Serial #______Model ______Sra ______*ScheduledInstallationDate______*Serial # ______*KVHDealer *KVH TracVision ProductModel *AMEX VISAMASTERCARDDISCOVER *Credit Card#*Exp.D - - *SS# E-mail______*Phone ______*Zip ______*State ______*City ______County *Street Address ______*LastName MI______*First Name Customer Information: DIRECTV.com andwithyourfirstbill. programming,receiptofyourleasedreceiver, andactivationofaccesscardsshallbeappliedinconjunctionwithth DIRECTV DIRECTV CustomerAgreement: FULLY ENFORCEABLEUNDERTHESETERMS. THIS PROGRAMMINGAGREEMENTISSEPARATE ANDDIFFERENTFROMANYOTHERANNUALAGREEMENTYOUMAY HAVE PREVIOUSLY MADEWITHDIRECTV Consequences ofTerminating theDIRECTVSubscription: Consequences ofYour FailuretoActivateProgramming: customersmayactivatereceive subscription.ExistingDIRECTV ($4.99 permonthadditionalreceiver)andmaintainyourDIRECTV programmingpackage.You alsoagreet Systemequipment,youagreetoactivateaDIRECTV Within 30daysofreceiptyourDIRECTV Thank youforchoosingtopurchaseDIRECTV. BysigningthisAgreement,Customer(hereafterreferredtoas“I”/“me”/“you”/“your Csoe intr______*ae______*Date *Customer Signature______DESCRIBED HEREINTOTHECREDITCARDDESIGNATED ABOVE.IHAVE READ ANDAGREETOTHEABOVETERMSCONDITIONS. BY SIGNINGBELOW, IHEREBYAUTHORIZEANDAGREE THAT KVHINDUSTRIES, INC.,MAY, AT ITSSOLEOPTION,CHARGETHEFEES I WARRANT THAT IAM18YEARSOLDOROLDERANDTHAT ALLINFORMATION SUPPLIEDBYORABOUTMEISACCURATE. ______*Phone ______*Zip______*City ______*State ______*Street Address ______*Customer orDealershipName Shipping Information: KVH Industries,Inc. •50EnterpriseCenterMiddletown, RI02842-5279U.S.A.•Tel: +1401847-3327•Fax: one hundred fifty U.S. dollars ($150.00), as liquidated , per DIRECTV System receiver that is not activated not is that receiver System DIRECTV per damages, liquidated as ($150.00), dollars U.S. fifty hundred one (DO NOTWRITEINTHISSECTION-TOBECOMPLETEDBYKVH) Information onReceiverSuppliedbyKVH Note: a $29.00 shipping and handling fee will be charged to the credit card designated above. designated card credit the to charged be will fee handling and shipping $29.00 a Note: Please contact DIRECTVforfinalactivation processing;call:1-800-DIRECTV (* fields are required for processing) for required are fields (* (* fields are required for processing) for required are fields (* You herebyagreeandacknowledgethatthisDIRECTVAnnualProgrammingAgreementsetsforthadditionaltermsconditionsrega a hsfr o418132.Ti saSCR FaxMachine. Fax thisformto401-851-3823. ThisisaSECURE (fill inall12digits-includingzeros) If youfailtoactivateyourDIRECTVSystemreceiverwithin30daysofreceiptfromKVH,agreethat Termination oftheDIRECTVsubscriptionwillrequirereturnleasedreceiverand/orearlyterminationfees. DIRECTV . rn/oe eil#Acs Card # Access Serial# Brand/Model ® Annual ProgrammingAgreement Promotional SystemActivationand Customer-owned ReceiverInformation e DIRECTVCustomerAgreement,acopyofwhichisprovidedat ”) agreestoabidebythefollowingtermsandconditions: swt hi xsigDRCVprogrammingpackage. rs withtheirexistingDIRECTV ciaeDRCVprogrammingonanyadditionalreceivers o activateDIRECTV ate 851-3823 • (MM) (YYYY) Internet: www.kvh.com KVH may charge a fee of fee a charge may KVH rding yourreceiptof AND IS

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