 Dream Limousine Service
P.O. BOX 2836 Turlock, CA
95381
Phone (209)664-1213
TCP#19918P
Toll Free Fax# 1-866-392-9792
E-Mail: info@dreamlimo.net Website:
www.dreamlimo.net
Credit Card
Authorization Form
I, ___________________________hereby authorize Dream
Limousine Service to debit my credit card in the below listed amount
or any amounts pre-approved by me. I understand that execution of
this authorization constitutes such approval. I assume full
responsibility for any and all non payments.
I
further understand that the below charges may change based on
gratuity, additional stops, parking, tools, and other miscellaneous
expenses.
Full Name:__________________________________ Date of
Service_____________
(As it appears on credit card) Time
of Service_____________
Credit Card #_________________________________ Type
___________________
Expiration Date________________ Security
Code___________
Home/Billing
Address:___________________________________________________
City
State
Zip
Phone#:
(_____)_______________(_____)_______________(______)__________________
Home Work
Cell
Terms and Conditions – Please Read Before
Signing
The above named client understands that all charges
are assessed from Dream Limousine Service. All unpaid deposits and
balances are authorized by the credit card holder by signed
acceptance of this contract. I am fully responsible for the repairs
and or re-placement of damage of and to the vehicle that I or any
member of my party creates. There is no smoking or illegal
substances in the vehicle at any time. The Chauffeur at their
discretion can terminate the charter if the client and/or their
guests conduct become unruly or illegal. I understand that I am
fully responsible for any vomiting in or on the vehicle and am
liable to pay a minimum charge of $250. All accounts not paid as due
and agreed upon here will be charged interest of 20%. If this
agreement is placed in collections the undersigned agrees to pay all
attorney and or collection costs.
All
reservations require a nonrefundable deposit of 20%. If this
reservation is not canceled in writing within forty-eight (48) hours
of the service start
time, the total amount will be
charged.
Signature:________________________________
Date: ______________________
Please return this
Authorization along with a copy of the front and back of your credit
card and a copy of your driver’s license or other valid
identification. Fax all documents to: Dream Limousine Service Toll
free fax #
1-866-392-9792 | 
