Create Corporate or Personal Account

Please complete the form below to send us an email. Fields marked with * are required in order to submit the contact form.

Date:*
Business Name:*
Address:*
City:
State:
Zip:

Telephone:*
Contact Person:*

Credit Card #*
Exp. Date:*
CVV:*

I agree to pay an 18% surcharge for the total amount of the invoice.

MINIMUM FOR VOUCHERS IS $15.00

This applicant firm assumes all financial obligations regarding charges incurred by personnel.

Riverdale Luxury Corp. has the right to verify the above information and refuse any company who has arrears with other companies and doesn’t comply with the Business Policy.

Bill will be sent monthly you may call to verify charge.

We don’t mail vouchers to companies for receipts or for accounting back-up, please keeps your pink copy for record in case any inconvenience may arise

This application authorizes Riverdale Luxury Corp. to apply charges on my C/C

C/C PAYMENTS WILL INCUR A FINAL 10% PROCESSING FEE

I agree to the terms stated above.

Customer's Signature*