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Rent To Own Agreement

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ABN 56 670 826 212

Rent To Own Agreement

Renter / Purchaser
Name:
Address:
Driver’s Licence Number:
Expiry Date: ____/____/____
State / Country of issue:
Date of Birth: ____/____/____
Mobile Number:
Email:
Authorised Driver
Name
Address
Driver’s Licence Number:
Expiry Date: ____/____/____
Make State / Country of issue:
Date of Birth: ____/____/____
Mobile number:
Email:
Vehicle
Registration Number:
Odometer Reading @ Check Out:
@ Check In:
Is the fuel tank full at Start of Rental? [Yes] [No]
Rental Period
Start Date ___/____/____
Start Time am/pm
End Date ____/____/____
End Time am/pm
Damage Excess
Payable for Damage, Third Party Loss or theft of the Vehicle
Up to $ (plus GST)
Rent to own application fee
Amount payable  (non refundable)
$
Rental Charges
Days:
@ $ per day
$
Excess kilometres (more than 700 kms per day)
@ $0.30 per km
$
Fuel:
@ $ per litre
$
Refuelling fee
$55.00
Other
$
GST
$
Total Rental Charges (including GST)
$
Credit Card Details
Credit Card type [__] Visa [__] MasterCard [__] Other: _________________
Name on the Card:
Expiry Date:
Credit Card Number:
CVV Code:
Pre-existing damage
Adaptive Resources
1.
2.
3.
4.
5.
6.
I have read the Rental Agreement and the Terms and Conditions and I agree:
(a)    to pay the Rental Charges as shown in the Rental Agreement; and
(b)    to be bound by the Terms and Conditions
Renter signature
Date
Authorised Driver signature
Date
BY SIGNING THIS RENTAL AGREEMENT YOU ARE AGREEING TO THE HIRE TERMS AND CONDITIONS.
VEHICLES MUST BE RETURNED (if hire) CLEAN AND FULL FUEL
BANK DEPOSITS
BANK NAME : ADAPTIVE RESOURCES WA
BSB : 062 692
ACC : 79720428
RENT TO OWN
MD : 31225
VEHICLE :
SELLER :
Adaptive Resources WA Pty Ltd
ADDRESS :
25 Rayment Street, Lathlain, 6100
MOTOR VEHICLE DEALERS LICENCE :
31225
CONTACT :
Toby – 0456698904
PURCHASER :
START DATE :
FINISH DATE :
(2 years from start date)
RENT TO OWN APPLICATION FEE :
$500 non refundable
RENT TO ONW WEEKLY PAYMENT :
If rent to own agreement is broken by purchaser at any time the agreement returns to a hire agreement and vehicle is returned.
INSURANCE / REGISTRATION / SERVICING is all covered by Seller (Adaptive) during Rent to own period, unless stated otherwise.
SIGNED
SELLER SIGN
DATE
PURCHASER SIGN
DATE
REFERENCE :
‘Insert the car rego of the vehicle you are hiring’