| Arrow
Express Messenger Service, Inc. |
| Corporate
Headquarters |
| P.O.
Box, 526421 |
| Miami,
FL 33152-6421 |
| |
| Company
Name: |
_________________________________________ |
| Address: |
_________________________________________ |
| City:
|
________________ |
State:_________ |
Zip:_____ |
| Email
Address: |
_________________________________________ |
| |
| Billing
Address: (if different) |
| Company
Name: |
_________________________________________ |
| Address: |
_________________________________________ |
| City:
|
________________ |
State:_________ |
Zip:_____ |
| Email
Address: |
_________________________________________ |
| Phone: |
_________________________________________ |
| Fax: |
_________________________________________ |
|
| Company
Information |
| Type of
Business: |
________________ |
How
long? ______ |
|
| Sole
Ownership: |
________________ |
Partnership______ |
Corporation: |
_____ |
| :Principal: |
________________ |
Title:
______ |
|
|
| Bank
Information |
| Bank
Name: |
________________ |
Contact: |
____________ |
| Address
/ Branch: |
_________________________________________ |
| Bank
Phone: |
________________ |
Account # |
____________ |
| "The
undersigned hereby gives permission for the release of
information regarding the above-referenced account" |
|
| Trade
References |
| Co.
Name: |
________________ |
Acct # |
________________ |
| Address: |
________________ |
Phone # |
________________ |
| Co.
Name: |
________________ |
Acct # |
________________ |
| Address: |
________________ |
Phone # |
________________ |
| Co.
Name: |
________________ |
Acct # |
________________ |
| Address: |
________________ |
Phone # |
________________ |
| |
| Arrow
Express Messenger Services, Inc. will not BE RESPONSIBLE FOR
THE COST OF ANY ITEM NOT DECLARED AT THE TIME THE ORDER IS
PLACED. OUR LIMIT OF LIABILITY IS 100.00 PER DELIVERY.
(The above information is submitted for the purpose of
opening an account of which payment is guaranteed by the
undersigned.) |
| Signed:
____________________________________________________________ |
| Title:
__________________________
Date:________________________________ |
Tomorrow's
deliveries today.