The Corporate Edge
  Application for Corporate Account Credit Line

 

  INSTRUCTIONS:
         1) Print out the application (Fill it out before or after printing).
         2) Fax it to us at 408-988-6556.
 
Note:  Please do not type beyond visible input boxes, when printing and faxing this form.
 
Personal and Confidential
   
Business Name:
Business Address :
Mailing Address:( If different)
City:
State:
Zip Code:
Business Telephone :  
Fax:  
Is your business incorporated?
Yes No
Number of yrs in   business :
State of Incorporation:
Federal Tax I.D. Number:
Brief Description of the Business:
 
        
Are you currently involved in any lawsuits?
Yes No
Are any lawsuits pending against this company?
Yes No
Has this company ever filed for bankruptcy?
Yes No
Are P.O. numbers required?
Yes No
Will this be a Credit Card Account?
Yes No
Credit Card Information:  
Type: Visa M/C AM/EXP DIS DINERS
Exp Date :
Name on card :
Credit Card # :
     
Affiliated Companies: (If applicable)  
Name Address Telephone Number
1
 
2
 
 
 Corporate Officers' Names:
       
CEO:
Controller:
President:
Secretary:
Vice President:
Treasurer:
INITIALS
   
 
 Names of Personnel Authorized to Charge Services:
 
1 6
2 7
3 8
4 9
5 10

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

 Bank References:
         
1 Name Address City State
 
  Phone/Fax#  
Account# & Contact Us
 
2 Name Address City State
 
  Phone/Fax#  
Account# & Contact Us
 

 Credit References:
         
1 Name Address City State
 
  Phone/Fax#   Account# & Contact Us
 
2 Name Address City State
 
  Phone/Fax#   Account# & Contact Us
 
3 Name Address City State
 
  Phone/Fax#   Account# & Contact Us
 
4 Name Address City State
 
  Phone/Fax#   Account# & Contact Us
 
5 Name Address City State
 
  Phone/Fax#   Account# & Contact Us
 

Credit Amount and Type of Account Requested:

         

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 10 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 LeGrande Affaire Limousine Service, Inc., to obtain payment for services rendered or for information and assistance LeGrande Affaire Limousine Service, Inc. 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.

The undersigned on behalf of the applicant authorizes LeGrande Affaire Limousine Service, Inc. to conduct a complete and thorough check of all the information supplied to LeGrande Affaire Limousine Service, Inc. 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 LeGrande Affaire Limousine  Service, Inc., to extend credit to the applicant knowing that LeGrande Affaire Limousine Service, Inc., will rely thereupon, furthermore the undersigned is fully aware of LeGrande Affaire Limousine Service's cancellation, reservation and billing policies, and will have in their possession a written copy of said policies included in the documentation entitled "Company History Structure Services and Policies".

  Authorized Signature(s) Title   Dated
1
2
3

 Initials