New Customer Applications

• Prepared by:

  Pa&NJ CAR RENTAL, LLc worker

  Pa&NJ CAR RENTAL, LLc Customer

• Specialist Identification Number:

  Emp387788- N. Smith

  Emp937788- Z. James

• Application Type:

  Employee

  Customer

• Job position

  Select Investors Coordinator Transporter Customer service Chief of Finance Department Manager Trainer IT Specialist Head of Administration Car Dealer Partner with Certificate lawyer or legal advisor Documents Designer Web Page Designer Sales Rep.

  • Investors
  • Coordinator
  • Transporter
  • Customer service
  • Chief of Finance
  • Department Manager
  • Trainer
  • IT Specialist
  • Head of Administration
  • Car Dealer Partner with Certificate
  • lawyer or legal advisor
  • Documents Designer
  • Web Page Designer
  • Sales Rep.
Applicant Name (Name is hidden for security reasons)

• Name:

• Account number for Employee or Customer: (Employee account number will start off with ‘Emp’ If the answer is customer, it’s mandatory to start off customer account number with ‘Cus’)

• Address: (Printed on driving license)

• Address: (House currently living in)

• Email:

• Sign up date:

  Date

• Is the customer account number provided correctly?

  Yes

  No

• Do u have a Valid Driver license?

  Yes

  No

• Drivers License Number?

• Please provide expiration date

  Date

• Please list the State on ur valid drivers license:

  Delaware

  Pennsylvania

  New Jersey

  New york

• Please provide last 4 numbers of social security number?

• Please provide Date of Birth

  Date

• Image upload section for driving license?

  Media

• Image upload of Person personally?

  Date

• Was the new account application submitted by self or Pa&Nj CAR RENTAL, LLc specialist?

  Select I filled out application on my own I was help by a specialist

  • I filled out application on my own
  • I was help by a specialist

• Will you be the only one listed under your account? (if no list all parties here)

  Select Yes for now No joint account with Parents No joint account with Sister or brother No joint account with Child or kids No joint account with spouse/partner or friend:

  • Yes for now
  • No joint account with Parents
  • No joint account with Sister or brother
  • No joint account with Child or kids
  • No joint account with spouse/partner or friend:
List all parties Name here

• Co-owner 2 of account Name:

• You are allowed to smoke in all PA&NJ CAR RENTAL, LLc cars and all vehicle will be cleaned when returned on the return date by company : Is anyone on your account a smoker: (Vapes, cigarettes, Marijuana or black and milds)

  Select Yes- me or one of co-owners of this account smoke. Yes- I be around smokers most of the time No- I don’t smoke at all

  • Yes- me or one of co-owners of this account smoke.
  • Yes- I be around smokers most of the time
  • No- I don’t smoke at all

• ALL NOTES:

• signature of main owner

  Sign

Account Signature of all Co-owner

• Co-owner sign here:

  Sign