Fueling Relationships Around The World ® World Fuel Services 9800 NW 41st Street Suite 400 Miami, FL 33178 Email: [email protected] Fax: +1-281-556-2586 World Fuel Services Europe Ltd 62 Buckingham Gate London, SW1E 6AJ United Kingdom Email: [email protected] Fax: +44-(0)20-7808-5145 World Fuel Services (Singapore) Pte. Ltd. 238A Thomson Road #08-01/10 Novena Square, Tower A Singapore 307684 EMAIL: [email protected] Fax: +65 6258 5487 ® BECOME A CLIENT FORM DATE RECEIVED COMPANY INFORMATION PARENT COMPANY INFORMATION Company Name Principal/Parent Company Street Address 1 Address Street Address 2 Company Registration Number Phone Number Primary Business Number of Employees City State, Zip/Postal Code & Country Phone Number Fax Number Website BILLING ADDRESS - SAME AS COMPANY CONTACT DETAILS - Primary Company Name Name Street Address 1 Position Street Address 2 City State, Zip/Postal Code & Country Phone Number Phone Cellular Fax Email Fax CONTACT DETAILS - Accounting CONTACT DETAILS - Chief Pilot Name Name Position Position Phone Cellular Phone Cellular Fax Email Fax Email FINANCIAL INFORMATION Website Stock Ticker Annual Revenues (USD) Country of Incorporation Number of Employees Type of Company Company Registration Number Federal ID Number Proprietorship Partnership Corporation Years in Business VAT/IVA/TVA Number Government BANK AND TRADE REFERENCES Bank Reference 1: Bank Name, Account Number, Address and Contact Information. Bank Reference 2: Bank Name, Account Number, Address and Contact Information. Trade Reference 1: Company Name, Address and Contact Information. Please don’t reference other charge cards Trade Reference 2: Company Name, Address and Contact Information. Please don’t reference other charge cards CREDIT REQUEST Requested Line of Credit Are any aircraft operated under an AOC Yes No Requested Terms of Payment Billing Preference Billing Currency USD GBP Email Mail Online Only Billing Unit of Measure CAD EUR OTHER USG LTR Fueling Relationships Around The World ® ® World Fuel Services 9800 NW 41st Street Suite 400 Miami, FL 33178 Email: [email protected] Fax: +1-281-556-2586 World Fuel Services Europe Ltd 62 Buckingham Gate London, SW1E 6AJ United Kingdom Email: [email protected] Fax: +44-(0)20-7808-5145 World Fuel Services (Singapore) Pte. Ltd. 238A Thomson Road #08-01/10 Novena Square, Tower A Singapore 307684 EMAIL: [email protected] Fax: +65 6258 5487 BECOME A CLIENT FORM FLEET INFORMATION AIRCRAFT 1 AIRCRAFT 2 AIRCRAFT 3 Tail Number Tail Number Tail Number Type of Aircraft (Make & Model) Type of Aircraft (Make & Model) Type of Aircraft (Make & Model) Owned or Leased Owned or Leased Owned or Leased Home Base Airport (IATA/ICAO) Home Base Airport (IATA/ICAO) Home Base Airport (IATA/ICAO) Owner’s Name Owner’s Name Owner’s Name Expected Monthly Fuel Consumption Expected Monthly Fuel Consumption Expected Monthly Fuel Consumption Continue on a separate sheet if more space is needed PRODUCT REQUEST Contract Fuel (Add Any) Aviation Charge Card WFS Contract Fuel AVCARD Additional Services # of cards _____ BaseOps International Trip Planning Alliance Contract Fuel (US Only) # of cards _____ REWARDS PROGRAM Your account/cards will automatically be enrolled in FlyBuys Rewards (a free loyalty program). Rewards Program Contact To opt out check here Email Phone *FlyBuys Rewards Applies to Business & General Aviation Customers Only WEB ACCESS INORMATION Contact Name Phone/Fax Email Address Username Require Access To Fuel Quoting Invoicing & Reporting My BaseOps ADDITIONAL INFORMATION Typical Destinations Served Seasonal Non-Seasonal Major Partners / Customers / Managed Customers Key Suppliers Signature Title Date Contact Phone Submit this application and supporting documentation by fax to 1-281-556-2586, by email to [email protected] or contact your local sales representative. FINANCIAL STATEMENTS Please attach your most recent interim Balance Sheet and Income Statement and your most recent fiscal year-end Balance Sheet and Income Statement. All financial statements must be signed and dated by an officer, owner or partner. If certified, audited or reviewed statements are available, they are preferred. A personal guarantee may be required. Financial statements and other Company financial information provided to World Fuel Services Inc. will be treated as confindential information. SIGNATURE APPROVAL AND ACCEPTANCE OF TERMS AND CONDITIONS 1. The Company warrants that the preceding information is true, correct and complete and agrees to inform World Fuel Services, Inc. in a timely manner of any ownership changes and/or material adverse changes to the Company’s financial position. 2. The Company authorizes (a) the references listed in this application to release to World Fuel Services, Inc. information related to the Company’s accounts and (b) World Fuel Services, Inc. to secure information regarding the Company’s credit history from any commercial or consumer reporting agency or trade organization. 3. The Company agrees that (a) all transactions for the purchase of products, including fuel or services are subject to World Fuel Services General Terms and Conditions found at www.wfscorp.com/wfscorp/docs/gtc-aviation.pdf and (b) all AVCARD transactions and Customer’s use of the AVCARD are subject to the Terms and Conditions for Aircraft Operation Use of the AVCARD Charge Card found at www.wfscorp.com/Aviation/Business_Aviation/pdf/wfs-ba-avcard-tc.pdf 4. If the customer is an LLC the signatory warrants he/she is a managing member.