Luxury Car Rentals of SA

RENTAL APPLICATION

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PLEASE PRINT APPLICATION AND SIGN                        Click here for Application

Luxury Car Rentals of SA

Rental Authorization & Reservation Form

1. Renter Information

1. Name:                                               2.   DOB:

    3.   E-mail address:                               4.  Address:

    5.  City:                  6.  State:                  7.   Zip Code:

    8.  Home Phone:                                   9.  Work Phone:  

   10.  Mobile Phone:                             11.  Driver's License:

   12. State:                                             13. SSN:

   14. Insurance Carrier:                       15.  Policy#: 

   16.  Agent Name:                                17.  Agent Phone:

Please circle one:

       Primary Renter       Additional Driver

2. Authorization

I, _________________________, hereby authorize Luxury Car Rentals of SA, San Antonio, Texas 78204, to procure a consumer report which I understand may include information regarding my credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. This report may be compiled with information from credit bureaus, courts record repositories, departments of motor vehicles, or any other source required to verify information that I have voluntarily supplied. I understand that I may request a complete and accurate disclosure of the nature and scope of the background verification, to the extent such investigation includes information bearing on my character, general reputation, personal characteristics, or mode of living.

If not booking a reservation - I authorize Luxury Car Rentals of SA to charge my credit card a non-refundable processing fee of $65.00 to obtain the aforementioned consumer report ($25.00 for each additional driver).

Cancellation Policy - I understand that when making a reservation, Luxury Car Rentals of SA may charge my credit card for 100% of the total rental cost or $200.00 (whichever is greater). In the event of a cancellation or reschedule, Luxury Car Rentals of SA will process that authorization as a "store credit" and apply the amount toward my rescheduled rental. I understand that if I cancel or reschedule less than 48 hours prior to my rental, I will be charged a 100% cancellation fee.

3. Reservation (Not final until confirmed by Luxury Car Rentals of SA)

Application Only. No reservation now, thanks. (Leave this section blank.)

Vehicle (circle all that apply):

Hummer H2         Ford Mustang Mach 1           Mercedes C230         Cadillac CTS

Rental Period Starting Date/Time:                                    AM     PM     (Circle)

Pick up from San Antonio office (No charge)      Deliver to:

Rental Period Ending Date/Time                                      AM     PM     (Circle)

Return to San Antonio office (No charge)           Pick up from:

4. Credit Card Information

Credit Card Number:

Expiration Date:

CVV (Security Code):

We will bill membership processing/application fees and/or rental charges to this credit card number. If you are booking a reservation, we will charge this credit card for the security deposit.

Your signature below signifies your approval of the above-state authorization, for your credit card to be charged for the application fee, additional driver fee and security deposit, and acceptance of our cancellation and refund policy.

Signed By_____________________________________________________

Date _______________________