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Overview
Complete
Car Rental Form
1GMDU24E12D182566 / AB9 C87 / 30 Jul 2020 / Hannah Jane Patts
Inspection score
100%
Failed items
0
Created actions
0
Car Rental VIN
1GMDU24E12D182566
Plate Number
AB9 C87
Year/Make/Model
2003 Dodge Caravan
Pickup Date

30th Jul, 2020

Prepared by
Hannah Jane Patts
Location
5000 Estate Enighed, Independence, KS 67301, USA (37.0910199, -95.71094269999999)
Inspection
100%
General
Customer Name
Kristina Jan Galey
Address
13-17 Neich Rd, Glenorie NSW 2157, Australia (-33.5885927, 150.9731025)
Driver's License Number
FCC681146
State
MO
Expires

1st Jan, 2025

Take a photo of License
Photos
Birthday

1st Jan, 1980

Telephone
6318942545
Date Out

30th Jul, 2020

Date Due In

3rd Aug, 2020

Mileage Out
160648
Mileage In
170000
Vehicle
Car Rental Rate
$125 per day
Gas Tank Reading
Full
Miles Allowed
300
Time and Mileage Charges
$100
Car Insurance
Insurance Type
Loss damage waiver
Own Auto Insurance
Auto Insurance Company
Budget D
Policy Number
AUX124569750
Expiry Date

1st May, 2022

Payment
100%
Fuel Policy
Full to Full
Additional Driver Fee
N/A
Total Charge
$390
Payment Received
Yes
Notes
Full Payment Received
Sign off
Car renter (Full Name and Signature)
Kristina Jan Galey
30th Jul, 2020 9:58 AM PST
Processed By (Full Name and Signature)
Hannah Jane Patts
30th Jul, 2020 9:58 AM PST
Media summary
1 Media file