Account Name:                                                                                                                                           

Name of Person(s) authorized use of account:                                                                                              

Address:                                                                                                        P.O. Box:                             

City:                                                                          State:                                 Zip:                                  

Credit Card Bank Name:                                                                                                                           

Address:                                                                                                       P.O. Box:                              

City:                                                                         State:                                 Zip:                                  

Type (circle):    M.C.      VISA      AMEX      DINERS      CARTE BLANCHE      DISCOVER

Account Number:                                                                                 Expiration:                                      

I                                                                                   hereby authorize Newtown Airport & Limousine

Service to bill the credit card(s) listed above for limousine service. The signature below will be considered

a "signature on file" for all future services.

Signature:                                                                                                     Dated:                                

* A 20% Chauffeur’s Gratuity Will Automatically Be Added To Your Bill *