Raceway Fleet Card Application

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Raceway Fleet card Application Mail or fax it to: Raceway Fleet card Program 1411 Stelton Road Piscataway, NJ 08854 Fax # 732-572-9715 For more information call 732-819-9116 APPLICANT- Please read the following before completing this form: (1) A representative of the company authorized to enter into contractual agreements must sign this Application . (2) The Personal Guaranty section must be completed and signed by an authorized officer of the company. (3) PLEASE READ AND SIGN BELOW BEFORE SUBMITTING THIS Application . Business Name: How long in business? Years Nature of Business ________________________________________ ______________________________ Type of Business: Partnership Corp. Sole Proprietor Federal Tax ID# Street Address: Address City State Zip Billing Address: Address City State Zip Pho

RACEWAY FLEET CARD DRIVER PROFILE The Raceway Fleet Card offers you the option to assign each card to a specific driver, vehicle or both. In addition, you also have the flexibility to assign specific charging privileges to each individual card.

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