Fleet Account Application

Ochoa's Tire Service · Family-Owned in Long Beach Since 1988

Cherry Ave
6595 Cherry Ave, Long Beach, CA 90805
562-422-4449

Paramount Blvd
6990 Paramount Blvd, Long Beach, CA 90805
562-395-4449

Complete this form and bring it to either location, or hand it to your service writer. We'll confirm your account and billing terms and your vehicles can start coming in right away. Questions? Call 562-422-4449.

1 · Business Information

Business / Company name

Type of business

Number of vehicles

Business address

City / State / ZIP

Years in business

2 · Billing & Authorizing Contact

Contact name

Title / role

Phone

Billing address (if different)

Preferred billing cycle

3 · Vehicles on the Account

#	Year / Make / Model	Plate or Unit #	Tire size	Notes
1
2
3
4
5
6
7
8

More than 8 vehicles? Attach a list or ask us to set up the rest at write-up.

4 · Authorized Drivers

People allowed to approve service and charges to this account.

#	Name	Phone	Approval limit (optional)
1
2
3
4

5 · Authorization

I certify the information above is accurate and authorize Ochoa's Tire Service to perform service on the vehicles listed and to charge the account per the agreed billing terms.

Authorized signature

Print name

Date

For office use: Account # ____________ · Terms ____________ · Approved by ____________