Owner Operator Setup Form

First Name Middle Last Name
Please enter your first name. Please enter your last name
Noramlly Called Date  
 
Carrier Since (mm/yyyy)  
Invalid format.A value is required.  
Address (1)        
Please enter street address.        
Address (2)        
       
City Province Postal Code    
Please enter your city Please select an item. A value is required.Please enter a valid Postal Code    
Business Phone Check Preferred Contact #      
     
Home Phone        
Invalid format.      
Cell Phone        
     
Email Address        
Invalid format. Can we send you reports and info by email?       
Select method of payment below. (we will contact you upon recieving this online form)  

(A minimum of 6 cheques are required)



    
     
Serices approved for charge (check)    
 
  Platinum Program (as specified below)    

Current Year Platinum Program fees:
1.  All payments charged first of the month.
2.  Past due full amounts owing must be paid before services completed.
3.  Sole Proprietor Fees include: One-time, non-refundable setup fee $129.00 plus GST, twelve monthly payments of $129.00 plus GST starting Jan ending Dec.   Corporations and Partnerships have slightly higher fees, contact us for details.  The Annual fee is 12 times the monthly payment.  If you start the service mid year catch-up fees apply, call for details.
4.  Prior years will be dealt with on an individual basis, please contact us to discuss.

  
Number of years as an Owner Operator     
Type of Business Entity (check one)    
 

Do you presently use the services of (check all that apply):

  
   
   
   
   
Are you up to date on all Annual Income Tax filings?    
Are you registered for GST? If yes, BN#     
When do you file?        
Are you up to date on all GST filings?            
Last year filed Please select a valid item. Please select an item.
   
     
Truck Make Truck Model
A value is required. A value is required.
Year Engine Type
A value is required. A value is required.
Horse Power Total Odometer  
A value is required. A value is required. KMs     
     

Info for determining your goals and objectives for using ATBS Canada:
     
     
     
     
     
   
       
Please expand and be specific on your number 1 and 2 items above so we can serve you better: 
   
       
Completed by   A value is required. Date A value is required.Invalid format.