Application Form E-zone

Application Form E-zone
New Customer :	Renewal :
Primary account holder name:	Date :
additional name	Home Tel:
Company Name :	Work Tel :	Limitation of Carriers Liability Insurance is MANDATORY, no Liability whatsoever is assumed for delay in delivery or for consequential damages of any kind, such as a loss of income, loss of interest or loss of business opportunity, or any loss or damage arising from the inherent nature of the goods. Nieuwe Post NA NV does not agree to carry and it is agreed that Nieuwe Post NA NV accepts, no liability for items of unusual instrinsic value such as cash, negotiable securities, jewels, furs or like. Our method of operation includes inter alia carrying on board the aircraft, accompanied passenger baggage an unaccompanied airfreight. The term 'Courier Services' does not necessarily imply that a man will be on board the aircraft If the item has not been collected within one month (30 days) we reserve the right to dispose of the item as convenient.
address :	Cellular :
E-mail:	Fax :
Insurance : for packages	Accept
Date Started : ______________________________________
CUSTOMS AUTHORIZATION: I hereby authorized Nieuwe Post NA NV to clear and deliver all packages on my behalf. I will accept and refund any charge in so doing.
Name: ______________________________________	Signature:_____________________________________
FOR OFFICIAL USE ONLY - THIS PART TO BE COMPLETED BY NPNA N.V.
Name:
YOUR ADDRESSES ARE:
For Mail/Magazines only for Curacao & Bonaire Account # ________________ PO Box 669508 Miami FL 33166-9508	For Packages/Parcels only Account# __________________ 7620 NW 63rd. Street Miami FL 33166
for Windward Islands Account# _________________ PO Box 669506 Miami FL 33166-9508	* Rates subject to change without notice.
Membership fee in Nafl. Regular Customers 125.00	Membership fee in Nafl. Senior Citizens & Students 75.00

Authorized Signature :