Corporate Account Application

Name of Company

Address

City/State/Zip

Structure (Sole Proprietor, Partnership, Corporation, Non-profit)

Number of Years Trading As Name

Accounts Payable Contact	Title

Telephone	Fax

Nationwide Limousine will be you for all service usage on a monthly basis with the closing date at the end of every month after a probationary period of 90 days. Until that point, our accounts receivable dept. will require a credit card on file, unless each passenger will pay with his /her own company card.

Date

Print Name/Title

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