Академический Документы
Профессиональный Документы
Культура Документы
Corporate
Name of Person / Name of Company Address City SSN. /Tax ID Number Cell Phone Number Home Phone State/Zip Code Email Address Profession / Designation Work Phone Fax
Bank Reference
Name of Bank Type of Account
[Optional]
Credit Reference
Credit Card Number CVC No. Name as it appears on the card holders Signature You can fax us or email back. Type of Card Exp. Date
Card 1
Personal
OR
Corporate
Zip Code
Need monthly statement? Yes No Cell Phone Home Phone Work Phone Please mention your estimated number of Trips per month: ________ Trips
Credit Card Authorization [If not paying by check] **Credit Reference [At least one major credit card] I __________________________________ of ____________________________________
[Your Name] [Company Name] Credit Card Number Exp. Number authorize AZ Car & Limousine Service to Date chargeCVC my Credit Card for my Billing Zip Code Companys Transportation. I understand that this Credit Card will be billed monthly / weekly / after each trip. I understand that this account can be cancelled anytime providing prior notice in writing. Notecan [if any]: 2 You fax us[ or email back.
]
Exp. Date
CVC Number
Credit Card Number Exp. Date CVC Number List of Authorized Persons Billing Zip Code List of persons authorized to charge Limousine to this account under the responsibility of the applicant. [Attach additional sheet if necessary] 1. Name: 2. Name: 3. Name: 4. Name: 5. Name: 6. Name: