Taxi Diamond

MY ACCOUNT

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Order coupons
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Manage profile online
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REQUESTS

INFORMATION

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Request Form for Taxi-Charge Account

This form is only for creating new Taxi-Charge Accounts. If you want access to your existing Taxi-Charge Account click here.

Required fields marked with *

BILLING
	Institution * :
	Telephone * :	Extension
	Fax (optional)
	Contact Name * :
	Nature of Business * :
	Billing Address * :
	City/Province * :
	Postal Code / Zip * :
SHIPPING
	Institution (optional) :
	Department (optional) :
	Telephone (optional) :	Extension
	Fax (optional) :
	Shipping Address (optional) : same as billing address
	City/Province :
	Postal Code :

	President :		Vice-president :
	Secretary :		Controller :

	Bank Name :
	Address :
	Telephone :
	Account # :

	Creditor (1) :		Creditor (2) :
	Address :		Address :
	City :		City :
	Telephone :		Telephone :
	Fax :		Fax :

	Your First Name * :
	Your Last Name * :
	Your Telephone * :
	Your Email Address * :
	Password * :	(must be from 6 to 12 characters in length)
	Confirm Password * :	(must be from 6 to 12 characters in length)
	Terms and Conditions of Taxi-Charge TM Accounts The user of " Taxi-Charge TM " coupons is jointly and severally responsible for the payment of the full value along with the account holder. The Montreal Diamond Taxi Association ltd reserves the right to cancel use of said service by the holder on written notice to that effect. The holder recognizes that " Taxi-Charge TM " coupons are bearer coupons and therefore assumes full responsibility from the moment the coupons are delivered to the specified address. Consequently, the holder is responsible for the payment of all coupons used even in the case of criminal or fraudulent use. The holder agrees to pay upon receipt the full amount indicated on the statement issued by the Montreal Diamond Taxi Association ltd. Additional costs of 7% ( minimum $3.50 ) of the monthly invoice are included in the statement to cover related service costs. Any unpaid balance at the due date is subject to a 2% per month ( 24% annually) charge. Within fifteen (15) days of receipt of the monthly statement, the holder can question the validity of items on the statement by sending a written notice to the offices of the Diamond Taxi Association. Falling such a notice, the statement shall be considered valid and the holder shall not be allowed to question the statement later. The use of " Taxi-Charge TM " coupons shall constitute acceptance of the above conditions. I understand and accept the information and conditions appearing above. (required to continue)