<p> Satcom Direct Customer Service Agreement (“CSA”) V2015.29.01 ACCOUNT PROFILE</p><p>COMPANY INFORMATION</p><p>Customer Name: </p><p>Mailing Address: </p><p>City: </p><p>State: </p><p>ZIP: </p><p>Country: </p><p>Telephone Number: </p><p>Fax Number: </p><p>CONTACT INFORMATION</p><p>Aviation Manager: </p><p>Email Address: </p><p>Chief Pilot: </p><p>Email Address:</p><p>Director of Maintenance: </p><p>Email Address:</p><p>Aircraft Technical Contact: </p><p>Email Address:</p><p>BILLING INFORMATION</p><p>Same as above Use the same billing contact information as tail number (Existing customers): </p><p>Company Name: </p><p>Contact Name: </p><p>Address, City, State, ZIP: Country: </p><p>Billing Telephone Number: </p><p>Billing Fax Number: </p><p>Provide an email address for electronic delivery of monthly invoices (REQUIRED): </p><p>PAYMENT METHOD (Check one) *You will be contacted by Satcom Direct’s Finance Department to collect your credit card details.</p><p>Check</p><p>Wire Payment</p><p>Credit Card*</p><p>PO (DUNS Required) DUNS #: </p><p>AIRCRAFT PROFILE</p><p>Aircraft Type: </p><p>Aircraft S/N: </p><p>Tail Number: </p><p>ICAO Home Airport Code: </p><p>Country of Registration: </p><p>EXISTING PROVIDERS</p><p>Have cabin services been provided by another service provider? Yes No If yes, please list provider </p><p>*Please select cockpit datalink provider: Satcom Direct Honeywell GDC Universal Weather ARINC Direct None</p>