[NEW] Equipment Rental Form

Equipment Rental Form
This form is used to autofill this rental agreement template.

By filling out and signing this form, you, the Borrower, agree to all the terms of the template linked above, as they relate to the form data, and give permission for InterAccess to transfer all relevant signatures and data from this form to the rental agreement template to create a complete agreement.
Date of Contract*

MonthDayYear
Date
Are you renting this equipment on behalf of an organization?*

Yes, a non-profit organization.Yes, a non-profit organization and charity.Yes, a for-profit organization.No, this is for my personal use.No, but it is for a DIY/grassroots/unincorporated collective.
If you answered "Yes" to the above question, please fill out the following according to the organization that is borrowing the equipment.

If you answered "No" to the above question, please fill out the following according to your personal information.
Full Legal Name of Borrower*
c/o
If you are renting on behalf of an organization, change "N/A" to your name.
Borrower Email*
example@example.com
Borrower Phone #*
Please enter a valid phone number.
Legal Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you an InterAccess member?*

YesNo
Address of Equipment Use*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Purpose of Rental
Rental Logistics
Status*

Return CompletePartial ReturnEquipment OutRequest-in-ProcessRequest Cancelled
RE: The section below —

Please add a new row for each piece of equipment you wish to rent.

If there are details you are unaware of, you may leave that column blank.

Please find a complete list of our equipment and all associated rental costs and security deposits via our Equipment Loan Breakdown Table.

Please don't forget to click "save" or "update" for each relevant row addition.
Equipment List*
Total pieces of equipment*
Total rental cost of equipment *
Total security deposit*
RE: Selecting a PICK-UP/RETURN date & time —

Please request a date & time between 11:00-18:00 from Tues-Sat.
Pick-Up Date & Time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Email of Staff Person Coordinating Pick-Up*
Return Date & Time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Email of Staff Person Coordinating Return*
Contract Signature
Signature of Renter

Clear
Name of Renter

First NameLast Name
Date Signed by Renter

MonthDayYear
Date
STAFF ONLY
Signature of InterAccess Signing Authority — CONTRACT

Clear
Name of InterAccess Signing Authority — CONTRACT

First NameLast Name
Role at InterAccess
Date Signed by InterAccess Signing Authority — CONTRACT

MonthDayYear
Date
Email of Signing Authority*
example@example.com
Full Return Confirmation

For InterAccess staff to sign ONLY when all equipment has been returned. For partial/incomplete returns, initial the row of the returned item in the section.
InterAccess Signature — RETURN

Clear
Name of InterAccess Signing Authority — RETURN

First NameLast Name
Date Signed by InterAccess Signing Authority — RETURN

MonthDayYear
Date
Should be Empty:

Equipment Rental Form

Rental Logistics

Contract Signature

STAFF ONLY

Full Return Confirmation