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01-Corporate Application Form - 112021

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JAAA-CLIENTF-0002

7 Central Avenue, Swallowfield, Kingston 5. Tel: 926-1939-40, 929-1200-1


E-mail: jaa.advance@mcsystems.com Website: www.calljaa.com Toll free: 1-888-call-jaa

Fuel and Fleet Management


Application Form

Business Information

Name of Company: _____________________________________________________________________________________________________

Account Administrator’s Name: _______________________________________ Title: _____________________________

Cell #: ______________________ Work #: ______________________ Email: ____________________________________

Type of Business: ____________________________________________ Business TRN: ____________________________

Type of Incorporation: Ltd Liability Public

Partnership Private

Years of Operation: ________________________________________________________________________________________

Business Address: _________________________________________________________________________________________

__________________________________________________________________________________________________________

Business phone #: ______________________________ Business Email: ___________________________________

List of Directors: 1) _______________________________________ 2) ________________________________

3) _______________________________________ 4) ________________________________

5) _______________________________________ 6) ________________________________

Affiliate Companies: 1) ________________________________________________________________________________

2) ________________________________________________________________________________

3) ________________________________________________________________________________

4) ________________________________________________________________________________

Banking Information

Name of Bank: _____________________________________________________________________________________________

Bank’s Address: ____________________________________________________________________________________________

Type of Account: Overdraft Deposit / Chequing

Loan Other

Chequing Account Number: __________________________________________________________________________________

Credit Line

Number of Vehicle: __________________________ Average Fleet Monthly Expenditure ($): _______________________

Security Type: Prepayment

Bank Guarantee

1
JAAA-CLIENTF-0003

7 Central Avenue, Swallowfield, Kingston 5. Tel: 926-1939-40, 929-1200-1


E-mail: jaa.advance@mcsystems.com Website: www.calljaa.com Toll free: 1-888-call-jaa

Credit Application Addendum

Name of Company: _________________________________________________________________________________________________

Directors Information
Name Email Home Address Cell #

What is the nature of your business? ___________________________________________________________


______________________________________________________________________________________

List the companies you have a credit relationship with.

Company Name Address Phone# Contact Name Durations Credit Terms

Prepared By: _________________________ _______________________ ___________________


Name Title Signature

This applicant agrees to supply further information as Jamaica Automobile Association (JAA) requires for the purpose of
processing this application. The applicant agrees that if one or more credit cards are issued in respect of this application and
one or more of such cards are signed by an unauthorized signatory, the applicant shall be bound by the terms and conditions of
use, a copy which is attached hereto.

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