Affiliate Signup

You will be required to provide:
1) Vehicle information (License Plates)
2) Driver Information (Drivers License)
3) A PDF copy of Insurance Certificate.
4) Complete W-9 Form with eSignature.

Contact Information









Company Information













Insurance Information



#





(Upload a PDF of your Insurance Certificate)





IRS Requirment

You are required to send us a PDF of a Signed & Dated W-9.
You can obtain that PDF using either of the methods below.

Option A) Complete, Print, Sign, and Scan a W-9.    
To scan a PDF, use the Office Lens app:        

Option B) FAX your documents to (203) 628-4011.
Include your phone number, and we will call to sign you up.


(Upload a PDF of a W-9 with Signature)

Service Information




YES     NO    

YES     NO    

YES     NO    

YES     NO    

YES     NO    


Fleet Information


YES     NO    

YES     NO    

YES     NO    

Android     iOS    


List of Vehicles


Type Pass Bags Year Make Model Color ST Plate
click to edit
   (Please provide Licence Plates!)


List of Drivers


Name EMail Phone SMS ST DL#
click to edit
   (Please provide Drivers Licences!)


Affiliate Logo





      (optional)


Login Name:*
New Password:*
Verify Pass:*
 

NOTE: Applications without complete information including DL#'s, LP's, and signed W-9 will be denied.