Sample Form for Car Rental and Lease
Car Rental Agreement
Vehicle Check Out: ____/____/______ @ ____: ____ AM / PM
Vehicle Is Due Back: ____/____/______ @ ____: ____ AM / PM
Odometer Reading: @ Check Out ___________________ @ Check In _________________
Car Renter:_____________________________________________________________________
Home Address: _________________________________________________________________
City: __________________________ State: _____ Zip: ____________ Country: _____________
Driver’s License Number: ______________________ State: ____ Expiration: ____/____/_____
Date of Birth: ____/____/______
Local Address: __________________________________________________________________
Auto Insurance Company: _____________________ Policy Number: _____________________
Credit Card: [__] Visa [__] Master Card [__] American Express [__] Other: _______________
Credit Card Number: ________________________ Name on the Card: ___________________
Expiration Date: ____/____/______ Security Code: ______
Additional Driver: _______________________________________________________________
Home Address: _________________________________________________________________
City: __________________________ State: _____ Zip: ____________ Country: _____________
Driver’s License Number: ______________________ State: ____ Expiration: ____/____/_____
Date of Birth: ____/____/______
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