; NY Star Limo Travel Agent Registration Form To receive commissions
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NY Star Limo Travel Agent Registration Form To receive commissions


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									NY Star Limo
Travel Agent Registration Form To receive commissions, please read and complete all sections below. Documents 1, 2, and 3 are required. Please send the following: 1. 2. 3. 4. This form with your signature as certification A copy of your IATA or CLIA certificate A completed Form W-9 or Form W-8 from the Internal Revenue Service A list of reservations and dates of service in need of commission payment (optional) DATE______________

Please Complete All Sections Travel Agent

Name_______________________________________ Telephone_________________________________________Fax__________________________ E-Mail_______________________________________ Travel Agency ARC/IATA/CLIA No._________________________ Telephone #__________________________ Agency Name______________________________________________ Street Address ____________________________________ ____________________________________ ____________________________________ ____________________________________ City ____________________________________ State ______________ ZIP Code______________ Country ____________________ After all required documents have been received, please allow five (5) business days for processing. For any inquiries, please call 877-310-0101 or 212-410-0101 Fax Completed Documents to

All of the information that I have provided on this form is correct to the best of my knowledge and I am authorized to submit this registration form. I understand that this application is subject to approval. I authorize Manhattan Limo Coach to make any inquiries that it considers appropriate to determine if it should pay me commissions. This may include verification of employment. Signature________________________________ Date_____________________________

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