Information Requested to Initiate VAT / MOT Recovery Engagement
(Upon receipt of this Information Request, CB VATAmerica - Aviation Division will prepare and forward an engagement agreement and other administrative documents for signature.) |
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| Legal Name of Company: |
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| Company Address: |
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| Company Website URL: |
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| Brief Description of Operations: |
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| (Example: corporate flight department, cargo charter, etc.) |
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| For US-Based Companies: |
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| IRS Number (EIN): |
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| (If Company is included in a consolidated tax return, please list parent company name and EIN.) |
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| Business Activity Code Number: |
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| (From Sched K of corporation tax return,or Page 1 of partnership tax return) |
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| For Non-EU, Non-US Companies: |
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| Please obtain and forward several original copies of a tax registration or corporate registration certificate issued by your local tax or corporate administration. |
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| For ALL Companies: |
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| Name, address and account information for wire transfers: |
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| (If blank, USD checks sent by mail to Primary Contact) |
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| For ALL Companies: |
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| Primary Contact: |
Name: |
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| (Person that we'll contact with announcements, updates and engagement coordination) |
Title: |
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| Address: |
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| Tel: |
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| Fax: |
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| Email: |
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| Signatory: |
Name: |
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| (Person authorized to sign administrative documents) |
Title: |
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| Address: |
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| Tel: |
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| Fax: |
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| Email: |
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| Access to Claims Status Reports: |
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| Please list name and email address of additional people authorized to access your Company's Claims Status Reports at www.cbvatamerica.com |
| Please return this completed form to CB VATAmerica LLC - Aviation Division
344 Nassau Street, Princeton, NJ 08540, Fax +001 609 430 4961
Attn: Michele Zalma, Claims Manager, or click "Send Information" |
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