Affiliate Registration

Name*

First NameLast Name
Office Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
All of the following documents:
Driver license*

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Chauffeur Profile Picture*

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Public Vehicle drivers License issued*

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Full Body Photo in Professional Attire*

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COMPANY:
W-9 Form*

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Business reg/corp certificate*

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Tax ID Certificate*

Cancelof
County Cert. of Public Convenience*

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Void Check*

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Please upload your rate sheet *

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Vehicle:
How Many vehicles are you OnBoarding?*
5 vehicles or more contact us at partner@CoachmanGloabal.com
Certificate of Liability Insurance Minimum $1,000,000*

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Vehicle registration*

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Limousine Permit sticker*

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Commercial Auto Insurance Identification card*

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Photo of the vehicle showing plates and decals*

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Do you understand and meet the above requirements?*

YesNo
Please note: We only work with registered companies. We will ask you to send specific documents at a later step.
Should be Empty: