Car Check Out - CrazyCars.com.au

Company Representative

Car Details for Check Out
Unique Ref and Registration
Select the unique reference for the car (Key Number, Name and Registration)
Click Auto Complete Fields or Enter Rego (Capital Letters)
Registration Vehicle
Vehicle Model
Normal Unique Ref
Car Type
Car Year
Key Number
The key number for the vehicle
Weekly Subscription

Weekly rental paid
Weekly Subscription $ per Week
Can adjust this if a different rental is agreed
Allowable KMs
Included KMs per Week
Weekly km allowance available. Base kms per week is 500km per week unless additional subscription is paid.
Day Subscription Due
Day Ezidebit subscription is paid
CAR CONDITION
Odometer Reading kms
Current Km Level
Fuel Level Kms to Empty
150 km to empty
Fuel Level %
Floor Mats and Type
4 Kia Sportage Mats
Rips (Yes/No
Jack Kit
Burns or Stains (Yes/No
Interior Condition
Windscreen Chips
Any known issues with the vehicle?

www.CrazyCars.com.au feel good drive
Electronic Signature Disclosure

You have been sent a document for digital signing. By clicking proceed, you agree to have read our Electronic signature disclosure.

www.CrazyCars.com.au feel good drive
Personal Details

Car subscription details
Name

PrefixFirst NameLast Name
Date of Birth (DD/MM/YYY)

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Mobile
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bank details

Used for insurance setup with Budget Direct (Billed Fornightly or Monthly)
BSB
Enter 6 digit BSB
Account
Enter Bank account
Account Name
Enter Bank account name
Emergency Person Name

First NameLast Name
Emergency Person Mobile
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Person Email
example@example.com
Licence Details
Type of Licence (Australian or International)
Drivers Licence Number
Drivers Licence Number
State of Licence
Licence type
What licence type do you have.
Any other Drivers?

Please note this increases the weekly rate by $15 per driver.
Yes or No
Other Driver Name

PrefixFirst NameLast Name
Other Driver Date of Birth (DD/MM/YYY)

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Other Driver Type of Licence (Australian or International)
Other Driver Licence Number
Drivers Licence Number
Other Driver Mobile
Please enter a valid phone number.Format: (000) 000-0000.
Other Driver Front of License

Cancelof
Other Driver Back of License

Cancelof
Work Details
Work Name
Your works legal name
Part Time or Full Time
Work Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Work Website
www.bunnings.com.au
Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

CASH RECEIVED

Also Input Bank amounts received. Bank + Cash = TOTAL
$ Up-Front Fee (Bond) Cash
$ Up-Front Fee (Bond) Bank
Total $ Up-Front Fee (Bond) Cash + Bank
Explain any reduced/delayed Bond payment?
i.e. Received 750 today but paying the balance of 250 in 3 weeks time. etc.
$ Subscription (Rental) Cash
$ Subscription (Rental) Bank
Total $ Subscription (Rental) Cash + Bank
CrazyCars Representative Name

First NameLast Name
CrazyCars Signature
Should be Empty:

Company Representative

Weekly Subscription

Allowable KMs

CAR CONDITION

Electronic Signature Disclosure

Personal Details

Bank details

Licence Details

Any other Drivers?

Work Details

CASH RECEIVED