ACCOUNT SET UP FORM ǁ HST REGISTRATION #: 8197-08926-RP0001 COMPANY INFORAMTION Name: Address: Phone #: Fax #: E-mail: Industry:

Film Production

Event Production CONTACT PERSONS

Primary Contact

Accounting Contact

Name:

Name:

Phone #:

Phone #:

E-mail:

E-mail:

Shipping Contact

SPECIAL REQUEST / NOTE:

Name: Phone #: E-mail: CREDIT CARD ON FILE – Payment Card will not be charged without prior written notice Credit Card Information: Please Complete All Fields

CARDHOLDER’S NAME (AS IT APPEARS ON CARD)

CARD NUMBER

CARD TYPE

EXPIRY DATE (MM/YY) ADDRESS OF CARDHOLDER

CITY

PROVINCE

SIGNATURE

POSTAL CODE

DATE

Acknowledgement 1. It is hereby agreed and understood that information contained herein shall only be used for charges, deposits, and/or preauthorizations related to the services and/or products supplied or to be supplied. Further, this information will not be shared, distributed, or otherwise used for any purpose other than the described without my express written permission. 2. I acknowledge that Abso Rental has my authorization to charge the Credit Card for further orders that may be placed with Abso Rental on behalf of the Customer. 3. I acknowledge my acceptance of additional charges that may be debited to the Credit Card for late return charges, damages, and/or loss of equipment supplied to Customer. 4. I understand that the Security Deposit charged to the Credit Card is fully refundable if the rental equipment is returned on time and in good condition, as defined in the Master Rental Agreement. 5. By signing above, I agree to be bound by the Terms and Conditions contained in the ABSO Rental Agreement and agree to pay any and all costs associated with the services and/or products, having personally read and understood said Terms and Conditions.

FOR OFFICE USE ONLY – Client ID #

ABSO RENTAL SERVICES 22 Jutland Road, Unit C, Toronto, ON Canada M8Z 2G9

RECEIVED BY:

APPROVAL DATE:

416-255-FILM (3456) tel 416-255-5852 fax www.absorental.com