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NOTICE CONCERNING FURNISHING OF NEGATIVE INFORMATION

Account Number:

Date:

From:

Fluz Fluz, LLC

234 Fifth Ave

2nd Floor

NY, NY 10001

Cardholder Name:

Cardholder Address:

Fluz Fluz LLC, may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.

I (We), the Accountholder(s), acknowledge receipt of this Notice Concerning Furnishing of Negative Information, and acknowledge that I (we) understand and agree to its provisions.

Signature(s): __________________

Date: __________________