BLS ACCOUNT APPLICATION
[pic]
( CORPORATE Account Application ( INDIVDUAL
Applicant Name: ________________________________________________________________________________________________________
Company Name: _________________________________________________________ FED I.D. # / SS#________________________________
(If applicable)
Company Address:
Address: _____________________________________________ City: __________________ State: __________ Zip: ___________
Billing
Address: _____________________________________________ City: __________________ State: __________ Zip: ___________
Telephone # ___________________________________________ Fax # _______________________________________________
Home Address:
Address: _____________________________________________ City: __________________ State: __________ Zip: ___________
Telephone # ___________________________________________ Fax # _______________________________________________
E-mail Address: __________________________________________________________________________________________________________
Credit Card Information:
( Amex ( Master Card ( Visa ( Discover ( Diners Club
Card Holder Name: __________________________________________________________________________________________
Address #: ___________________________________________ City: __________________ State: __________ Zip: ___________
Telephone # ___________________________________________ Fax # _______________________________________________
Credit Card # ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( Exp.: ( (/( (
An attached copy of the Front and Back of the Credit Card must accompany this Application.
Bank Information:
Bank name: _____________________________________Account #: _______________________ Phone #: _________________
|Business References: |
| |
|Name/Address: ______________________________________________________________ Phone #: ___________________ |
| |
| |
|Name/Address: ______________________________________________________________ Phone #: ___________________ |
The undersigned herby acknowledges and agrees that BLS is relying upon the within application in extending luxury ground transportation service to this applicant. Additionally to avoid the inconvenience to each passenger of signing charge records at the conclusion of each transfer, the undersigned herby authorizes the Credit Card Company to permit this application to serve as my authorization to charge the above credit card in lieu of signing individual charge records or travel and entertainment sales slips for each rendered service.
Print Name: _______________________________________ Signature: ______________________________________________
Please Fax completed application to: ______________________________ Attention: _______________________
BLS Office use only
Account #: _______________________ Date Opened: _______________________ Rate Group: _______________________
Opened by: _______________________ Approval #: _______________________
BLS Limousine Service, Inc 18-20 Steinway Street, Astoria, NY, 11105 Worldwide Reservations (800) 843 5752 Fax (718) 267-5452
For general terms and conditions go to:
terms
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- fafsa application 2019 20 application pdf
- vanguard brokerage account application form
- vanguard account application form
- application to application integration
- bsp savings account application form
- new bank account application form
- fidelity brokerage account application form
- my account ancestry account page
- wells fargo application access your application status
- create new outlook account new account outlook
- customer account application form
- bank account application form