ApplicantDate *Name *Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountry ContactMobile Phone *Home Phone Email * LicensingDFHV Face ID *Exp. Date *DL Number *State *Exp. Date * Rental History (Company 1)Company Date (From) Date (To) Rental History (Company 2)Company Date (From) Date (To) Terms and Conditions It is understood and agreed by the Renter that the rent for the above vehicle will be paid weekly by Cash in advance by no later than 5:00pm Saturday for the following week. The weekly Rental period is Sunday to Saturday. The Renter will be sole operator of the vehicle at all times and will not be loaned to any other persons. Renter is responsible for reporting and paying all moving and parking violations issued against this vehicle during the rental period. Renter is responsible for ensuring that the vehicle has valid tags, current proof of insurance and is equipped with a jack, spare tire, lug wrench and appropriate levels of oils and fluids. Renter is responsible for all equipment installed in the vehicle such as mobile data terminal, printer, GPS antenna and taximeter. Renter is responsible for performing basic rental vehicle maintenance and reporting promptly any noted deficiencies. Renter is responsible for any damage to the rental vehicle other than the normal wear and tear during the rental period. Renter must bring in the vehicle weekly to the Yellow Cab Co. garage for inspection. Renter is responsible for returning the vehicle to the above location at the end of the lease during business hours 08:30AM - 4:00Pm (Mon - Fri) and 9:00AM to 12:00PM (Saturday). Renter gives permission to the owner to contact previous owners on driving record and work performance. The owner of this vehicle is not responsible for any liability should this agreement be violated.I acknowledge that I read and understand the above terms and conditions *YesInstructions VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>:
