Commuter Van Quote Request
Register under Corporation or Individual Name? 登记在公司名字还是个人名字?
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Corporation 公司
Individual 个人
Company Name 公司名称
Tax ID/EIN 公司税号
Name 姓名
First Name
Last Name
SSN 社会安全号
Contact Name 联系人
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First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Mailing Address 收信地址
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Street Address 街道号码和名称
Street Address Line 2
City 城市
State / Province 州
Postal / Zip Code 邮编
Garage Address 停车场地址
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Street Address 街道号码和名称
Street Address Line 2
City 城市
State / Province 州
Postal / Zip Code 邮编
Commuter Van Routes Starting Point (巴士线路起点站)
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Commuter Van Routes End Point(巴士线路终点站)
*
Driver List 司机信息
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Vehicle List
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Please Upload Driver's Driver License 请上传司机驾照
Browse Files
Drag and drop files here
Choose a file
Cancel
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Please Upload Commuter Van TLC License 请上传司机TLC驾照
Browse Files
Drag and drop files here
Choose a file
Cancel
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Please Upload Affiliated Commuter Van Base License or Letter 请上传小巴公司站头信
Browse Files
Drag and drop files here
Choose a file
Cancel
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Do you need down payment assistance? 是否需要首付款协助?
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Yes 是
No, I am able to make the payment now and get reimbursement within 30 days. 否,我可以先付款后等待30内退款;
Do you need assistance for us to apply the Grants? 你需要我们协助申请此项补助吗?
*
Yes 是
No 否
Submit
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