PERSONAL ACCOUNT APPLICATION FORM

          *PLEASE PRINT AND FILL OUT ALL INFORMATION COMPLETELY AND ACCURATELY AND MAIL OR FAX TO THE ABOVE ADDRESS OR NUMBER. A LIBERTY/YELLOW CAB REPRESENATIVE WILL CONTACT YOU SHORTLY REGARDING SETUP.

YOUR NAME:__________________________________

POSTAL ADDRESS
IF APPLICABLE:__________________________________________

STREET ADDRESS:____________________________________________

PHONE NUMBER:__________________________

FAX NUMBER:_________________________

SOCIAL SECURITY NUMBER:________________________
(COPY)

LICENSE (COPY):____________________________

MOBILE NUMBER (OPT):_______________________

E-MAIL ADDRESS
IF APPLICABLE:___________________________________

FOR PERSONAL ACCOUNTS WE DO REQUIRE A $100.00 DEPOSIT BEFORE THE ACCOUNT IS ACTIVATED. YOUR DEPOSIT IS SOLEY USED FOR THE PURPOSE OF OPENING YOUR ACCOUNT WITH US AND IS REFUNDABLE SO LONG AS THERE ARE NO MONTHS OWED TO LIBERTY/YELLOW CAB.

    BILLING IS STRICTLY WITHIN 10 DAYS OF INVOICE
    WE GLADLY ACCEPT ALL MAJOR CREDIT CARDS.
*Liberty/Yellow Cab reserves the right to approve or deny any application.
 
 
 
 
 
 
 
 
 
 

IMPORTANT POLICY

Please understand that, we, at Liberty/Yellow Cab go to great lengths to protect our clients from account fraud by guarding their accounts as "confidential." It is our strict policy that we do not provide callers with account numbers when placing cab orders. When a caller is unable to provide their account information, they are asked to call back when they can. This is a security measure that was adopted to protect our clients from any potential fraudulent use of their account.

For your personal/company's vital protection, your account number should not be given out to anyone. If for some reason you decide to provide your account number to anyone, you do so in understanding that your personal/company account is responsible for payment without exemption. It is important that anyone having an access to your account information is informed, aware, and abides to the travel parameter/limitations by you or your organization(i.c. no waiting time allowed, travel allowed only to specific locations, etc.) Your personal/company is solely responsible for the payment of services rendered by passengers or employees' "misuse" authorized to travel on your account.

We do appreciate your business and strive to ensure that you receive the best possible service. Please feel free to contact me at anytime for any special needs, requests, questions or concern you may have.

Sincerely,

Mary J. Ventura
Accounts Manager

X_____________________________ (Signature Required)
**Liberty Cab reserves the right toapprove/deny application**