3012 N. Lindbergh Blvd. Ste 'B'., St. Louis, MO 63074 Tel:314-738-0100, Fax: 314-738-0600

ACCOUNT / CREDIT APPLICATION Thank you for the opportunity to serve you!

Name of business or individual to whom credit is to be extended  ____________________________________________________________ Phone: _______________

Address:_________________________________________ City:___________ State:____ Zip:______

Type of Business: __________________________________________________________________

If your firm has ever operated under a different name, please list name and address __________________________________________________________________________________ __________________________________________________________________________________

Please indicate the name and address of the person to whom billing should be directed __________________________________________________________________________________ __________________________________________________________________________________

Has business declared bankruptcy in the last 14 years?______Yes______No

Authorized Representatives Are: (Minimum of two if corporation or partnership)

Full Name: __________________________________________ Title:__________________________ Full Name: __________________________________________ Title:__________________________ Full Name: __________________________________________ Title:__________________________

Bank

Bank: ______________________________________________  Acct.No:______________________ Address / Brench:___________________________________________________________________ Bank: ______________________________________________  Acct.No:______________________ Address / Brench:___________________________________________________________________

Any changes in this application must be in writing on file at Royal Car Service LLC.

Signed:________________________ Date:________ Signed: _________________ Date:__________

For Office Use Only

Date:____________________________________ Assigned Account No.:______________________ By Sales Person: ____________________________________________________________

Payment must be made within 14 days after receiving bill.