Car Rental Agreement Form

• Vehicle Plate Number

• Date out

  Date
• Location
  Address

• Prepared by

General

• Car Renter Name

• License Number

• Identification

  Media

• Date of Vehicle Return

  Date

Vehicle

• Gas Level

  Select Full 7/8 3/4 5/8 1/2 3/8 1/4 1/8 Empty

  • Full
  • 7/8
  • 3/4
  • 5/8
  • 1/2
  • 3/8
  • 1/4
  • 1/8
  • Empty

• Mileage Limit

• Vehicle Date Out Photos

  Media

Agreement

• Car renter agrees to pay a $35 processing for every parking and/or ticket violation incurred?

  Yes

  No

  N/A

• Car renter agrees to have full responsibility and will pay $250 for any interior damage, including but not limited to: cigarette burns, holes and cuts, excessive dirt, cigarette odors?

  Yes

  No

  N/A

• [This is a sample car rental agreement] - Terms and Conditions:
  
  Only the person(s) that are listed on this Car Rental Agreement and above the age of twenty-one may drive this vehicle. The Car Renter is hereby responsible for all collision damage to the vehicle regardless if someone else is at fault or the cause is not known. The Car Renter is fully responsible for the cost of any repair up to the value of the vehicle. The Car Renter's Insurance may cover all or only part of the financial liability for the rented vehicle. Car Renter should check with their insurance company regarding their coverage and what they are and are not liable for. If there is no breach of this contract the Car Renter and any authorized driver is provided liability insurance and is limited to the minimum financial responsibility as required by state law. Liability Insurance will only be in excess over any and all additional collectible insurance. The Car Renter hereby waives all uninsured and underinsured motorists, no-fault, and any other optional additional coverage. If such additional coverage cannot be waived or excluded then the Car Renter agrees that such coverage will be limited to only the minimum state requirements.
  
  The Car Renter is hereby bound by the terms and conditions of this Car Rental Agreement. The vehicle must be returned to the same location in which it was picked up for rental and on or before the above indicated due back date and time. There will be additional fees due if the vehicle is not returned as specified above. Where it is permitted by law the Car Renter hereby authorizes us to process their credit card information in their name for all Car Rental charges, including the full vehicle value of any vehicle that is not returned to the Car Rental Company, all fines, towing, any court costs, penalties, and or administrative fees that we may incur for parking, traffic and or other violations that may be incurred by the Car Renter during the Car Rental term period as stated above and to apply any payments made to the charges in whatever order that the Car Rental Company sees as necessary. By signing below Car Renter is also signing their Car Rental credit card voucher.

• Car renter agrees with the above terms and conditions

  Yes

  No

  N/A

Sign off

• Renter Full Name and Signature

  Sign

• Processed by (Full Name and Signature)

  Sign