CRYSTAL Transportation & Tours
Reservations: (866) 823 8380
Nationwide Transportation Network
CORPORATE CREDIT APPLICATION
Please return this Authorization by fax to: (714) 279 0904 or email to accounts@crystaltrans.com
****For security purposes, please include a copy of the front & back of credit card along with a valid identification for the cardholder ****
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BUSINESS NAME: ________________________________________________TYPE OF BUSINESS_______________________________
BUSINESS ADDRESS: _____________________________________________CITY,STATE,ZIP__________________________________
MAIN OFFICE # _______-________-____________ FAX: _______-________-___________ EMAIL:______________________________
CONTROLLER/ACCOUNT PAYABLE: ____________________________________ DIRECT PHONE: ________-________-___________
CREDIT CARD INFORMATION:
CARDHOLDER NAME : ____________________________________________________________________________________________
BILLING ADDRESS: _____________________________________________ CITY, STATE, ZIP ________________________________
PHONE: HOME: ________-_________-______________WORK: ________-_________-___________CELL:______-________-_________
Card Type: pVISA pMasterCard pAmerican Express p Discover
CARD NUMBER # __________________________________________________________ EXP DATE: _________/___________
I, the undersigned, authorize CRYSTAL TRANSPORTATION & TOURS to debit my credit card for transportation and related services, which may be rendered for the above named organization.
Cardholder Signature: _________________________________________________________ Date: __________________