Rental Car Application

First name

Last name

Multi-line address

Country/Region

Address

City

Zip / Postal code

Birthday

Month

Day

Year

Company name

Address

Phone

Has your driver's license been suspended or revoked in the past? Enter answer No Or Yes. Upload current MVR under requirements.

Have you ever been convicted of a DUI? If so, has it been discharged. Enter Answer No. Or Yes upload current MVR under requirements.

Do you consent to provide proof of income? Yes or No. Please upload screen shot of gig booking as proof of income under requirements.

Do you consent to provide proof of insurance through your gig? Yes or No. Please screen shot proof of insurance and upload under requirements.

Do you understand that you must be 25 years old and older to rent vehicle? Yes or No

Do you agree to use E350/luxury vehicle only for Uber or Lyft? Yes or No

Do you understand that the E350/luxury vehicle cannot be used for AmazonFLEX, GRUBHUB, Walmart, Doordash, UberEats, or personal gigs? Answer Yes or No

Do you understand that the Fusion/economy vehicle can be used for AmazonFLEX, GRUBHUB, Walmart, Doordash, UberEats, or personal gigs? Yes or No answer

Do you understand that the vehicle can only be operated in the state of Georgia? Answer Yes or No

Do you understand that the rental terms must be not less than 3 days and a maximum of 5 days. And that a new contract must be signed to extend rental. Answer yes or no

Do you understand that payment must be made at the start time of rental agreement. And payment must be made at the start time of rental extension. Answer yes or no

Do you agree to leave a debit/credit card on file for rental charges? Answer Yes or No. Upload front picture of valid legible card under Requirements.

Do you agree to forward $200 or up to $500 maximum deposit upon approval of your rental car application. Yes or No

Signature

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Reference #1 First/Last Name; Address; and Cellphone Number

Reference #2 First/Last Name; Address; and Cellphone Number