The Dignity Personal Credit Application form is a comprehensive document designed by Dignity Transportation Inc., located at 900 Magnetic Drive, Toronto, Ontario, to facilitate personal credit applications. This form acts as a gateway for individuals seeking to obtain credit services, capturing essential information such as billing details, passenger information, employer’s details, and bank information. It meticulously collects data ranging from basic personal identification details, including Social Insurance Numbers and contact information, to more sensitive financial details like bank account numbers and major credit card information. Notably, the form offers an option for invoices and back-ups to be emailed, enhancing convenience and efficiency for the applicant. It also inquires about the need for wheelchair-accessible vehicles, demonstrating inclusivity and attention to varied customer needs. The form sets out clear terms and conditions, covering everything from pricing and gas surcharges to payment terms and conditions for order cancellations or changes. It explicitly states the company’s policies on billing disputes, late payments, and legal actions for overdue accounts, ensuring that applicants are fully informed of the financial obligations and the procedural formalities involved in credit application and maintenance. Moreover, by consenting to the exchange and disclosure of information with third parties, applicants allow Dignity Transportation Inc. to verify the accuracy of the provided information and conduct necessary investigations, an essential step for the integrity of the credit process.
| Question | Answer |
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| Form Name | Dignity Personal Credit Application Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | infodignitytransportation, M3J, Expiry, undersigned |
900 Magnetic Drive
Toronto, Ontario, M3J 2C4 |
Tel: (416) |
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Fax: 1 (866) |
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Email: info@dignitytransportation.com |
Toll Free: 1 (866) |
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Website: www.dignitytransportation.com |
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PERSONAL CREDIT APPLICATION
Billing Information
Name: |
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S.I.N. |
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Postal Code |
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Yes |
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No |
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Home Telephone Number
Business Telephone Number
Mobile Number
Passenger Information (if different from above)
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Name: |
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Email Address: |
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Address |
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Home Telephone Number |
Business Telephone Number |
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Mobile Number: |
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YES
NO
Employer’s Information
Employer |
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Employer’s Address |
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Employer’s Telephone Number |
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Current Position |
Years in Current Position |
Years with Company |
Annual Salary |
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Bank Information
Bank/Trust Company
Account Number
Address
Major Credit Card
Visa
Mastercard
Card Number
Expiry Date:
Major Credit Card
Visa
Mastercard
Card Number
Expiry Date:
In applying for credit with Dignity Transportation Inc., the undersigned consents to Dignity Transportation Inc. obtaining from, exchanging with or disclosing to a third party all information concerning the applicant for the purpose of ensuring the accuracy of this information and conducting investigations.
TERMS AND CONDITIONS
1)All pricing will be as per the most recently published Dignity Transportation Inc price list.
2)A gas surcharge may be charged as per said price list.
3)All changes or cancellations of orders must be made through the dispatcher of Dignity Transportation Inc.
4)No show and cancelled at the door will be charged as per Dignity Transportation Inc policy.
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6)No account may be cancelled retroactively.
7)If there is a dispute on a charge, it must be forwarded in writing within 15 days of date of invoice or it will not be accepted and the full charge will be due and payable.
8)Dignity Transportation Inc will measure all distances using appropriate computer software and charge accordingly.
9)Terms of payment are net 15 days from date of invoice and an overdue fee of 2% per month will be charged on late payments.
10)From time to time due to unusual weather or road conditions the vehicle may be late and Dignity Transportation Inc does not accept any responsibility in late arrival or no show fees administered to the client.
11)Orders will only be accepted by the authorized person or persons. These orders may be emailed, faxed or phoned in.
12)Should legal action be required to collect an over due account, the insurance company is responsible for said expenses.
The Undersigned hereby authorizes Dignity Transportation Inc. to collect any overdue balance on my account by charging one of the above credit cards.
Applicants Name/Please Print
Date
Applicant’s Signature