ACCOUNT APPLICATION – Credit Card Account

Name of business

Year established

Address *

City *

State / Province *

Postal code *

Country *

Phone *

Mailing Address (If different than above):

Person in charge of transportation *

Contact No. *

Email *

Kindly provide an email address to receive all reservation confirmations (if applicable):

Check box if confirmations are to be sent to the individual traveler

Confirm

Kindly provide an email address to receive all reservation trip receipts (if applicable):

Check box if receipts are to be sent to the individual traveler

Confirm

Please indicate reservation requirements (department code, etc, if applicable):

I hereby authorize Vitesse Worldwide, to use my credit card below for any ground transportation service rendered, current or future.

Check this box if Credit Card is to be collected from individual passengers

Yes

Credit card provided below will be listed as a backup payment on account if the box is checked.

Credit Card Number *

Expiration Date *

CCV#: (3 or 4-digit code that is found on the front or on the back of your card *

Credit Card Billing Address *

I hereby authorize Vitesse Worldwide to use my credit card above for any Ground Transportation service rendered, current or future.

Full Name *

Title

Date *

Please upload front image of your credit card *

Please upload back image of your credit card *

Terms and Conditions:

The company is responsible for all orders, changes and rides taken on this account. This includes “no show” charges or “late cancels”. In order to close the account, Vitesse must be notified in writing. If the company changes its name, a new application must be submitted. Vitesse reserves the right to charge the company`s credit card on file.

I understand the Terms and Conditions: *

Yes

I have received the Rate Sheet *

Yes

IMPORTANT: THIS APPLICATION MUST BE SIGNED BY A SENIOR OFFICER

I have read the above and hereby agree to all terms and conditions.

Full Name *

Date *

Additional Information

Please list any specific requirements you may have

Please list your top VIP’s

Name of VIP 1
Name of VIP 2