Phone: 1-214-912-5466 Fax: 1-214-346-9776

Web: www.mylimodfw.com

Billing Account Application Form

Please fill in the following information

Date

______________________________________________________________

Custmor Name.

________________________________________________________________

Business address

________________________________________________________________

Mailing address (if differeNT)______________________________________ _____________________________________________________________

City State Zip________________________________________________________________

Contact Person E-Mail Address______________________________________________________

Phone number ________________________________________________

Credit Card Number____________________________________________

Expiration Date_________________________________________

Credit Card type Last 3/4 digit Security Code__________

Print Name as it appears on the Credit Card

___________________________________________

Authorized Cardholder Signature

x________________________________

    MLD. mylimodfw@yahoo.com .Fax 1-214-346-9776

Name of personnel Authorized to charge services

1. ____________________________________________

2. ____________________________________________

3. ____________________________________________

4. ____________________________________________

5. ____________________________________________

6. ____________________________________________

(Name) (Title)

Of, _________________________________ am authorized to act as agent/representative

(Company Name)For, _________________________________ in entering into this Agreement to open a (Company Name)

Billing Account effective _________________________________for the purpose of

charging all Limousine/Transportation services. I agree that and/or

_________________will be held fully responsible for payment of all charges

made to this account. In addition, I agree to the following terms:

1. Payment is to be remitted within 14 days of the invoice date.

2. There is a $30 fee for each returned/insufficient check.

3. A finance charge of 10% per week for any unpaid invoices exceeding 14

Net terms.

By signing below, I certify that all the information I have provided in this application is true

and complete

X_________________________________            _______________

       (Authorized Representative)                                    (Date)

I authorize MY LIMO DFW  to charge the above credit card for any charges due.I understand that I may be charged minimum of $150.00 stretch or mini bus /coach buses and /or up to 50% cancellation fee for any Sedan/SUVs service ordered that is cancelled 24 hours(game days/proms or holidays 72 hours) after the reservation was made.

FOR YOUR PROTECTION SEND US COPY OF YOUR DRIVER`S LICENSE AND CREDIT

CARD WITH THIS FORM.

Prices do not include 20% service fee and DFW Airport Toll ($5) fee plus any other tolls paid.

Personal Information:

MY LIMO DFW Transportation, its parent company and its divisions, and affiliates do not sell rent or disseminate your personal and financial information to any outside third parties. We use the information supplied to provide requested services and collect payment for services rendered in accordance with our rates, terms and policies.

Reservations: Reservations made online are not guaranteed until you have received a confirmation from MLD Transportation. Online reservations may besubmitted up to 24 hours prior to your requested pick-up time. To request reservation with less than 24 hours advance notice, please call our offices direct at 214-912-5466 and speak to one of our reservation specialists. A valid credit card is required when booking a reservation.

No Smoking Policy- My Limo DFW Transportation maintains a clean environment;therefore smoking and eating is NOT allowed in any of our vehicles.

MY LIMO DFW IS OWNED BY

A CENTRAL LIMOS.

**  Please read our cancellation policy: www.acentrallimo.com