| InTouch USA Cellular Rental Request +1-703-222-7161 Fax: +1-703-222-9597 www.intouchusa.com |
RATE FOR WIRELESS RENTALS FOR USE IN
THE US |
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|
Equipment rate: $39 weekly, $89 monthly Credit Card Deposit: $250 per week Minimum use per day: 3 Minutes US Round Trip Shipping: $19 second day. |
Airtime- Local & US calls: $0.99 per minute in major cities ($1.50 in
rural areas). Additional charge for international calls. Carrier Surcharge: 9.75% on airtime used. |
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To use where? (Phones may be returned from other destinations)
Destinations:_____________________________
Start/Return dates: ____________to___________
Credit Card (type): IMPAC
Amex
Visa MC Discover
Purchase Order
Name on Card:___________________________________________
Account or Purchase Order
# _ __________________________________ Expires:______________
Billing Phone # + Country Code:_______________________________________________________
Credit Card Billing Address:___________________________________________________________
________________________________________________________________________________
Ship to (if different from above or if to Hotel or Business):
Name (if not to billing person):_________________________
Phone:__________________________
Company/Hotel:______________________________________
Floor/Suite:_____________________
Street Address: ____________________________________________________________________
City/State/Zip:______________________________________________________________________
Transaction: By signing below, client authorizes InTouch USA to process credit card vouchers in
client's name and pay all charges incurred under the terms and conditions of this
agreement. Airtime use is determined by reading phone meter
and verifying against carrier invoice.
__________________________________________________________ _____________________________
Card holder's signature
Date
Initial for theft protection $2 per
day
covers 1/2 replacement cost.
FAX application, copy of credit card (front and back),
& drivers license or passport
to 1-703-222-9597.
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