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Corporate Account Form Fax to 561-688-1775 E-mail to info@klassykoach.com |
Billing Name ____________________________________________________________
Billing
Address___________________________________________________________
City
___________________________ State___________ Zip Code _________________
Phones: 800# (
)____________ Office ( )____________Fax ( )____________
Email
= _______________________
http://www. _______________________
Contact
Person ___________________________________________________________
Credit
Card # ________________________________________Exp. Date______/_____
Social
Security # ______________ - ______________ - ______________
Drivers
License #
Federal
Tax ID# __________________________________________________________
Authorized Users
Name Pickup Address Phone
______________________________________________________________________________________________________
______________________________________________________________________________________________________
_____________________________________________________________
In making this application for
credit, the customer agrees to pay all invoices within 30 days from date of
invoice. In the event, a suit is necessary to collect any amount,
the customer agrees to pay the seller’s reasonable attorney fees and costs
including attorneys fees for appeal.
Signature
_____________________________________ Date ___________