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New York Limousine Service
new york limousine service

Fax Reservation Form

Please fill out this New York limousine service form on line, then click the "PRINT" button below.
Fax this form to: 1-516-481-3357

This form is arranged for New York airport service.

For any other service, please fill in your special request in the comment box below

Passenger First Name:	Last Name:
Street Address:	City:
State:	Zip:
Country:
Phone:	Mobile Phone:
Your Email:	NOTE: CONFIRMATION SENT TO THIS EMAIL

Street Address or Airport Name:
Address2 or Airline Name
City or Arriving From:
State/Providence or Flight No.:
Zip/Postal Code or Arrival Time:	(ex:16:30)

Destination:	Other:
No. Passengers:	Handbags: Suitcase: NOTE: OVER 8 SUITCASES WILL REQUIRE THE LUXURY VAN.
Type of Car:
Date of Pickup:
Time of Pickup:

Credit Card Type:
Credit Card Number:	Exp Date: (mm/yy)
Name on Card:
Card Billing Address:	City:
State:	Zip:
Card Holder Phone:

By signing this limo service form you agree that (1) you are the credit card holder and (2) that you are requesting the services listed above and (3) that you are authorizing this card to be used for the New York limousine service requested.

Cardholder's Signature: _________________________________ Date: ___________

24 hour / 7 day a week limo reservations