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Fecha de Revisión:
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CREATION AND UPDATE CUSTOMER FORMMarzo 2013
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Rev: 02
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GENERAL INFORMATION
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NAME /TRADE NAME/LEGAL NAME
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LEGALLY ESTABLISHED AS
Person
Company
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MAIN ADDRESS
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COUNTRY
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CITY
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STATE
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COUNTY
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POSTAL CODE
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PHONE
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FAX
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E-MAIL
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TAX PAYER IDENTIFICATION NUMBER
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BUSINESS INDUSTRY
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IATA CODE
(CASS 11 Digits-IATA PAX Code 8 Digits)
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CONTACT INFORMATION
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COMERCIAL CONTACT PERSON
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POSITION
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PHONE
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PHONE AFTER HOURS
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E-MAIL
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FINANCIAL CONTACT PERSON
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POSITION
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PHONE
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E-MAIL
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BILLING INFORMATION
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MAILING ADDRES
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PERSONS AUTHORIZED TO RECEIVE INVOICES
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PHONE
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E-MAIL
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TAX INFORMATION
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EXEMPTYesNo
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APPLICABLE TAXES
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Aviabca Holdings S.A. acting on its own behalf and as mandatory for companies Aerovías del Continente Americano S.A Avianca, Aerolíneas Galápagos S.A Aerogal, Taca International Airlines S.A., Líneas Aéreas Costarricenses S.A, Trans American Airlines S.A y Tampa Cargo S.A, is the company responsible for the management of data in this form, database to be managed from Colombia and El Salvador. The client knows that the information can be used by all and / or related companies and / or their parent and / or administered by Colombia, El Salvador and Ecuador, and may be transferred to the corresponding database. Agree Not Agree
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As a client of Avianca, accept the conditions set out in this form, and I certify that the information described above is correct and agree to keep it current, allowing also will check the veracity of it.
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Based on which sign: Day ____ Month _______ Year _____.
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Signature and Name of the legal representative
Received by the Company (Signature and Name)
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Avianca Holdings S.A. guarantees the confidentiality of the information and exclusive use of the obligations of this document for the companies mentioned above.
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