| Cardholder Name:______________________________________________
Company Name:
______________________________________________
Billing Address:
______________________________________________
E-mail Address:
______________________________________________
Home Phone:
______________________________________________
Business Phone:
______________________________________________
Cell Phone:
______________________________________________
Fax Number:
______________________________________________
Credit Card Information:
1VISA
1MasterCard
1American
Express 1Discover
1Dinners
| Card Number # ______________________________
|
EXP ____________ |
I the undersigned, authorize the limo service to charge my credit
card for my transportation.
I Herby authorize my
signature to be on file with the limousine service. This letter,
photocopy, or facsimile of it will authorize the Limo Service to
charge my credit card for my future transportation.
I personally guarantee
all credit card payment for the limousine service.
No show will be billed at
full price.
Late cancellation less 24
hour will be billed at full price.
In addition you must
photo copy the front and back of the card holder credit card and
drivers license.
This application will not
be accepted with out proper identification.
Please fax your document
to 201-525-1424
| Card Holder Signature:
_________________________ |
|
|