Areas with an asterisk (*) must be completed. Applicant must upload or fax copies of registration cards for 15 company-owned/leased vehicles after completing this form. Fax number: 201-263-7313; Email: Fleetoperations@mbusa.com. Applicant for Corporate Account Number (CAN) must be an officer of the company. Processing time for applications is two business days from when all materials (completed form, registration cards, lease documents, etc.) have been received. Please note that Corporate Account Numbers (CANs) will not be issued to the following: Known Exporters, Rental Agencies/Retail Leasing Companies, Automotive Brokers, Car Dealerships, Companies Purchasing Vehicles for Customization, Taxi Service Companies, Government Agencies and Ambulette / Medical Transportation Companies. Note: to be eligible for the Mercedes-Benz Fleet Program, vehicles must be new and unused.

1. Company Information

2. Company Officer

  • 3. Other Manufacturer's Corporate Account Number.

  • 4. Dealer Information.

5. Instructions for Corporate Account Registration.

To qualify as a registered corporate account, a company must meet the following criteria:

1) Operation of 15 or more vehicles (any make or model) registered in the company name.

2) Hard copy vehicle registrations must be provided after completing this form. Registrations in individual names, titles, or insurance cards are not accepted. Registrations must be for motor vehicles only; no trailers, boats, motorcycles, machinery, etc.

3) For leased vehicles, in addition to the registrations in the leasing company's name, a Buyer's Order or Lease Agreement or Master Insurance Policy listing the VINs to the company applying for the CAN.

Please use this portion of the form to attach proof of registration for 15 company-owned/leased vehicles. If you are unable to attach scanned copies of your documents, you must fax the documents to Fleet Operations at 201-263-7313. Review of applications will begin when all supporting documents have been received.

Note: Review of applications will begin when all supporting documents have been received. Please allow up to two business days for processing.

Review of your application can only begin after all supporting materials have been received.

By submission of this Qualified Corporate Account Enrollment Form, the undersigned hereby requests enrollment as a Registered Corporate Account and agrees to comply with the Official Program Rules with respect to any Mercedes-Benz incentive benefits as outlined in Official Program Rules. We acknowledge that this enrollment form will be continued from year to year and, as a condition of continued enrollment as a Fleet Program Qualified Corporate Account, we agree to comply with the Official Rules of the Programs, including applicable limitations and restrictions, established from time to time.

1. Mercedes-Benz USA, LLC reserves the right at its sole discretion to change program rules and guidelines and fleet incentives without notice, to verify accuracy of account data, to decline an application or to terminate a Corporate Account Number or Executive Allowance Control Number at any time on a case by case basis. All program transactions are subject to audit and chargeback to the dealer. 2. Purchaser hereby agrees that any information provided to or obtained by Dealer or MBUSA in confirmation of the Purchaser's participation in the MBUSA Fleet Program (including any and all personal information), is voluntarily provided by Purchaser and Purchaser hereby consents to MBUSA and Dealer's retaining said information for record and audit purposes and to the sharing of said information to affiliates and agencies for purposes of marketing Mercedes-Benz products and services. 3. Dealer and customer acknowledge and agree that MBUSA's issuance of a CAN or control number or approval under the MBUSA Fleet Program does not constitute an approval of or review by MBUSA of any transaction effected through the Program. It remains the Dealer's and Purchaser's responsibility to determine and comply with all Program qualifications of any transaction including compliance with use, export and resale restrictions. 4. Sale subject to any new car sales DDR Policy and Export Policy. Vehicles are intended for use in the USA and are subject to the limitations of the Export Policy. Fleet programs are not eligible for use with Brokers. Fleet incentive must be used at the time of purchase/lease.

1. I confirm that the information is complete, and accurate to the best of my knowledge and by submitting the application I have reviewed the Account Application Agreement and consent to the information being used for enrollment in the Mercedes-Benz Fleet Program.

Please note: Review of application will begin after receipt of this form and copies of registrations/supporting documents for 15 company-owned/leased vehicles. Please allow two business days after receipt of documents for review.

I also agree and consent for a copy of the approval/rejection email response to be sent to the above mentioned Mercedes-Benz certified dealership regarding this Corporate Account Number (CAN) Enrollment Application.

Submission Identification Number ()

Thank you for your interest in the Mercedes-Benz Fleet Program.

Your Corporate Account Number (CAN) application has been successfully submitted.

An acknowledgement email has also been sent to the business email address you provided.

If you chose to fax your registrations and/or lease documents and have not already done so, please send them now to 201-263-7313.

Review of your application will begin when we receive copies of the registrations and lease documents (if applicable) for the 15 vehicles you listed in your application form. Please fax these documents to: 201-263-7313. Please refer to the acknowledgement number above on any fax. This will help to expedite the review process.

Your application will be processed within two business days after receipt of all documents. A response will be sent to the business email address you provided.

Please print this acknowledgement for your records.

Mercedes-Benz USA, LLC Fleet Operations, One Mercedes Drive, Montvale, NJ 07645.

Note: This is an automated outbound email response only. For further assistance please contact Mercedes-Benz Fleet Operations at 1-866-628-7232 or visit www.Fleet.mbusa.com.