Signature Flight Support Aviation Card Application

The business entity described below ("Company") makes application to EPIC Card Services ("EPIC") for a Signature Flight Support Aviation charge card, for commercial or business purposes only. Company has obtained permission to include application information that personally identifies an individual, including their consent to transfer, process, store, use and disclose it internationally for lawful purposes.

*Company's Legal Name:
*Beneficial Owner:
*Identification:
Date of Birth: / MM / DD YYYY
% of Ownership:
Street Address:
City:
State:
Country:
Company dba Name:
*Billing Contact Name:
*Billing Address
*Street Address

Address Line 2

*City

*State / Province / Region

*Postal / Zip Code

*Country
*Contact Telephone:
*Contact Email Address:
Shipping Address for Card(s)
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
*Federal Tax ID Number:
*Monthly Credit Line Requested:
*Approximate Annual Fuel Gallons Purchased:
Flight Operations Information
*Contact Name:
*Telephone:
*Email Address:

Are you interested in becoming a Signature TailWins� member, receiving points for fuel and handling transactions?
Yes No Already a Member
Signature TailWins� Member Name
Signature TailWins� Number
*Base Airport ICAO
Area of Flight Operations: Domestic International
Referred By (FBO Name/IATA):
Inclusion in Signature's Network-wide profile
Do you want your new Signature Cards on file at All Signature locations (this allows for a faster checkout process)?
Yes No
Your new Signature Cards will be placed on file for (Check all that apply): Fuel All other Aviation Services (Hangar Rent, Ramp Fees, Catering, etc.)
Aircraft Fleet List
*Number of Aircrafts:(if more than 10, please email Fleet List to info@epiccardservices.com)
Aircraft Comments:
Please state how you would like the name of your company to appear on all card(s):
Authorization Agreement & Submission

Company hereby applies for an Signature Flight Support Aviation charge Card and represents, warrants and agrees that all information is true and correct and that EPIC may, from time to time: (1) order credit reports and obtain other information on Company from financial information listed; (2) use and disclose all information for verification and to maintain, enforce, and collect on any resulting account; and (3) furnish information to credit agencies and others, including affiliates.
By signing this application, Company agrees that it will be legally bound by the Signature/EPIC Card Account Agreement delivered with any card(s) issued if it does any of the following: (i) uses or allows others to use a card or fails to prevent use (including unauthorized use); (ii) activates a card (or allows others to do so) pursuant to instructions delivered with it; or (iii) without doing (i) or (ii), fails to terminate the card account within 30 days after its receipt of any card.
*Agree
*Company's Legal Name:
*Authorized Officer's Signature:
*Authorized Officer's Email:
*Print Name:
*Title:
*Date / MM / DD YYYY

Signature Flight Support Aviation Card Application

Signature Flight Support Aviation Card Application

Flight Operations Information

Inclusion in Signature's Network-wide profile

Aircraft Fleet List

Authorization Agreement & Submission