Credit Card Billing Account Application

Thank you for your interest in establishing a Credit Card Billing Account with BostonAsapCoach for chauffeured ground transportation travel services. This Credit Card Account can be used for both as a Personal or Corporate Credit Card Billing Account or for travel use. Our credit card billing account allows you to consolidate your accounting, by booking all rides for Yourself and all Company Employees under one account number.

Please note that with a credit card account, each ride will be individually billed to the credit card provided at the time the reservation is made. The credit card will be charged upon completion of the ride.

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ALL FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED.

Account Number:
(Office Use Only)

Tell us about your Company or Yourself

Company Name: (If Applicable)

Company Address: (If Applicable)(Street/City/State/Zip/Country)

Booking Contact Name*

Booking Contact Title: (If Applicable)

Business Phone Number:

Mobile Phone Number:

Fax Number:

Email Address:*

Payment Method Credit Card on File Authorization

All rides will be billed individually using the credit card that must be provided at the time of reservation is made. The credit card will be charged upon completion of the trip. Each of your rides will appear as a separate transection on your credit card statement.

Credit Card Account Number*

Credit Card Expiration Date*

Credit Card CVV Code*

Credit Card Holder Name*

Credit Card Billing Address:* (Street/City/State/Zip/Country)

Credit Card Account Holder Signature on File Authorization

I hereby authorize my signature to be on file with BostonAsapCoach for the purpose of charging transportation services on my credit card for my Personal and/or Guest use and/or Company Business Travel. I authorized the associated credit card company designated above to accept this form as in lieu of my signature appearing on each individual credit card receipt for transportation services rendered.

E-Signature of Approver

Please note that approver must be authorized user of the above listed Credit Card.

E-signature*

Date*

By typing your name in the box above and submitting this application electronically you are agreeing to the above listed Payment terms. Also authorizing BostonAsapCoach to verify the above information and debit your Credit Card for the Transportation Services rendered.

Credit Card Billing Account Application