Reservation - For Exotic Chauffeured Limousine Service in Los Angeles

	What is your Event?
	Wedding limo
	Prom limousine
	Quinceanera limo
	Airport Pick up limo
	Bach Party limo
	Night out in town
	ViP Transportation
	Birthday limousine
	Anniversary limo

Limo Request Form

Please fill out the following form and press the print button to print a copy of the filled out form. Then please fax us the completed reservation form to 323.315.5176

Card Holder's First Name:

Card Holder's Last Name:

Main passenger name:

Type of Occasion:

Pickup Date:

Total Hours:

Pick up & drop off Time:

Number of passengers:

Type of Vehicle(s):

Card Holder's Billing Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Work Phone:

Fax:

Email Address:

1st Pickup Address:

2nd Pickup Address (if applicable):

1st Drop Address:

2nd Drop Addrese (if applicable):

Credit Card Type:

Credit Card Number:

Expiration Date:

*Total Due:

Deposit:

Balance Due:

Signature:______________________ Date: __________

* By signing and faxing this reservation form the signee agrees to all the terms and conditions of Exotic ViP Limos. * You will be provided with the total amount due of the reservation at the time of the reservation being made with one of our staff members.