New Client Registration – State Line Pilot Car & Permit Service, LLC

STATE LINE PILOT CAR & PERMIT SERVICE, LLC

Office (585) 394-9364 Mon-Fri 9am-5pm

Fax (585) 393-4332

First time working with State Line Pilot Car & Permit Service, LLC?

Set up an account with our office for this & future orders. Simply fill out the "New Client Registration Form" and hit submit to process via secure website.

Unsure if your company has a pre-existing account?

Give us a call and we will gladly look it up for you.

On the road and requiring assistance?

Set up an account by phone

(585) 394-9364

Please fill out the client registration form. We require a credit card on file for all new customers, however, you may contact the office to arrange other payments methods if preferred.

New Contact Registration Form

"*" indicates required fields

Company Name*

Contact Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

DOT #*

FEIN #*

Phone*

Email*

Fax #

Credit Card Authorization Information

We require a credit card on file for all new customers, however, you may contact the office to arrange other payments methods if preferred.

Name as it appears on Card*

Card Type*

Master Card

Visa

American Express

Credit Card Number*

Expiration Date*

CVV/CVC code*

Today's Date*