SAMPLE - FICTIONAL EXAMPLE - NOT FOR FILING

CLAIRMONT GARDENS APARTMENTS LLC
600 LAURELWOOD CT
DECATUR GA 30030

DECATUR FAMILY DENTAL PC
315 W PONCE COMMONS STE 4
DECATUR GA 30030

MAGNOLIA BANK VISA
PO BOX 105411
ATLANTA GA 30348

MIDTOWN INSTALLMENT LOAN COMPANY
1100 SPRING GARDEN WAY
ATLANTA GA 30309

PEACH STATE DEPARTMENT STORE CARD
PO BOX 182273
COLUMBUS OH 43218

PIEDMONT AUTO LENDING
PO BOX 47120
ATLANTA GA 30362

SOUTHERN CRESCENT CARD SERVICES
PO BOX 70388
CHARLOTTE NC 28272