Accounts Payable Authorization for Automatic Direct Deposit of Vendor Payments (Please Print) Vendor Information: Street Address

City Tax Identification Number State Contact Name Zip code Telephone Number

Name:

Vendor ID No. (for internal use)

E-mail Address for Notification (Please provide an e-mail address if you would like to receive e-mail notification of direct deposit of funds)

Initial Authorization

Change Financial Institution

Change Account Number

Cancel Direct Deposit

Name of Financial Institution

Financial Institution Routing Number

Mailing Address

City

State

Zip

Type of Account

Account Number

I authorize The Carlyle Group to deposit reimbursements for goods and services into the account(s) identified above and held at the financial institution(s) named above. This authorization will remain in effect until the company above provides a new Authorization Form cancelling this authorization to the Accounts Payable Department in sufficient time and manner as to allow the Accounts Payable Department to act upon it.

Date Please print name

Authorized Company Representative Signature

Please print company title