CORPORATE ACCOUNT APPLICATION

**PERSONAL AND CONFIDENTIAL**
(encrypted for security)

INSTRUCTIONS:
1) Fill out and submit the form below, making sure to include all required fields.  Required fields are marked with a *.

-or-

1)  Print the form.
2)  Fax it to us anytime, at 514-351-3184.

BUSINESS INFORMATION:

* Business Name:    

* E-Mail Address:   

* Business Address:

Mailing Address (* if different) :

* City:

* State:

* Zip:  

* Business Telephone: * Fax:

* Contact Name and Phone #: 

* Is this Business Incorporated?  Yes No

* If so, number of years in Business:     

   State of Incorporation:            

   Federal Tax I.D. Number:      

* Brief Description of your Business:

* Has this company ever filed  for bankruptcy?  Yes No

* Are P.O. numbers required?  Yes No

ACCOUNT INFORMATION:

* Type of Account Requested:

Monthly billing  and our company will issue a check for payment within 30 days.

Monthly billing and I authorize you to charge my credit card at the end of the month for the whole amount.

I authorize you to bill my credit card at the end of each trip.

* Card Type: Visa M/C AMEX DISCOVER DINERS

* Name on Card: 

* Credit Card #:    * Expiration Date:

* Names of Personnel Authorized to Charge Services (at least 1):

(1)       (6)

(2)      (7)

(3)      (8)

(4)      (9)

(5)    (10)

(If needed, attach additional names of authorized personnel on your company letterhead.)

In the event that this credit application is approved, the applicant hereby agrees to and accepts the following terms and conditions: FULL PAYMENT SHALL BE DUE UPON RECEIPT OF STATEMENT. Failure to make payment in full within 30 DAYS of statement closing date will subject applicants account to a finance charge, which will be computed on the average daily balance at a monthly rate of 2% (ANNUAL PERCENTAGE RATE OF 24%).

In the event that the account remains unpaid and legal fees therefore are incurred by Montreal Doval Limousine, to obtain payment for services rendered or for information and assistance Montreal Dorval Limousines  may require from whatever source it deems necessary to obtain payment, the applicant shall be held accountable for all expenses incurred in the collection process, including reasonable attorney fees.

The undersigned on behalf of the applicant authorizes Montreal Dorval Limousines to conduct a complete and thorough check of all the information supplied to Montreal Dorval Limousines. Furthermore, the applicant certifies that the above statements are true, correct and complete and have been made by the undersigned for the purpose of inducing Montreal Dorval Limousines, to extend credit to the applicant knowing that Montreal Dorval Limousines, will rely thereupon, furthermore the undersigned is fully aware of  Montreal Dorval Limousines's cancellation, reservation and billing policies.

 * Authorized Signature(s)        * Title            * Date

(1)

(2)

(3)

* INITIALS: