You may pay for service with cash or with any major credit card, including MasterCard, Visa, Discover, American Express or Diner's Club. Your TaxiCard® or corporate charge account is welcome.

TaxiCard® is our stored-value corporate and gift card. Click here for more information about TaxiCard®.

Voucher accounts provide a convenient way to pay for and control your transportation costs. Each account holder will be provided a free supply of 3-part vouchers. These can be customized to capture information specific to your needs, such as client matter, patient number, etc. They can also be preprinted with restrictions pertaining to routes, destinations, and tips. Account holders can also authorize charges to an account when a voucher is not available, where the taxi driver creates a voucher at the time of the trip.

Invoicing is done at the end of each month. A detailed statement is prepared accompanied by each original voucher that was handed to the taxi driver. Terms are net 30.

Please complete the form below to apply for a voucher account. You may press the submit button at the bottom of the form for secure processing or you may print the form and fax it to (512) 434-7795. Please allow three business days for processing.

Name
Dept. or attention of
Street address 1
Street address 2
City
State	Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip Code
Phone number
Alternate phone
Type of Business
How long in business
How long at present address
Previous Address
City
State	Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip
Previous Phone
Person opening account
Social Security # (if individual account)
Title or Position with your company
Please list three credit references below, (one bank and two accounts)
Bank Name
Account Number
Phone Number
Contact
Address
City
State	Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip
Account Name #1
Account Number
Phone
Contact
Address
City
State	Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip
Account Name #2
Account Number
Phone
Contact
Address
City
State	Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip
I understand that this information furnished to you on this application is for the purpose of obtaining credit from Greater Austin Transportation Company. I am authorized in my capacity to commit my firm accordingly. Payment terms are NET 30.