Elektrica Rentals – Lease-to-Own Application

Elektrica Rentals – Lease-to-Own Application

Apply online for Elektrica's lease-to-own vehicle program.
Applicant Information
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Current Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Do you own or rent?
Time at Current Address
Prior Address
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Driver's License or Other Form of ID
Driver's License State
Driver's License Expiration Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Driver's License Front Photo

Cancelof
Vehicle You Want
Preferred make
Preferred model
Year range (from/to)
Preferred color
Max monthly payment budget
Desired down payment
Must-haves / other preferences
Employment and Income
Employment Status
Work and Job History
Current or most recent employer
Current or most recent job title
Current or most recent start date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Current or most recent end date (or present)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous employer 1 employer
Previous employer 1 job title
Previous employer 1 start date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous employer 1 end date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous employer 2 employer
Previous employer 2 job title
Previous employer 2 start date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous employer 2 end date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Monthly Income
Other Income Source and Amount
Desired Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
References and Additional Details
Reference 1 Name

First NameLast Name
Reference 1 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 Relationship
Reference 2 Name

First NameLast Name
Reference 2 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Relationship
Reference 3 Name

First NameLast Name
Reference 3 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 Relationship
Current Insurance
Insurance Carrier
Policy Number
Anything else we should know?
I certify the information is true and authorize Elektrica Rentals to verify it with my employers and references. No credit check is performed. Submitting does not guarantee approval.
E-Signature
Lease Disclosures
Applicants approved for lease-to-own will be required to maintain full coverage insurance listing Elektrica Holdings as loss payee.
I understand and agree.
You are leasing this vehicle. The title remains in Elektrica's name until the lease is paid in full. At the end of the lease, you may purchase the vehicle for a small buyout amount.
I understand and agree.
The battery is covered by a warranty while the vehicle is leased. If you choose to purchase the vehicle, there is no battery warranty from Elektrica after purchase, but any remaining manufacturer's warranty will carry over to you.
I understand and agree.
The lessee is responsible for general maintenance and tolls during the lease. This also includes normal wear and tear, tires.
I understand and agree.
The lessee will receive digital access to the vehicle. No physical key is provided.
I understand and agree.
Elektrica reserves the right to deny any application for any reason.
I understand and agree.
Should be Empty:

Elektrica Rentals – Lease-to-Own Application

Applicant Information

Vehicle You Want

Employment and Income

Work and Job History

References and Additional Details

Current Insurance

Lease Disclosures