ExtraCar - Rent a Car Online Form

Please fill in and submit this form to reserve a booking for a rental vehicle from ExtraCar.

Agency Details

Please note: fields marked with * must be completed

Agency Name: *

Cost Centre:

Branch: *

Billing Address:

Billing Email:

Agency Reference:

Contact Name for Enquiries: *

Phone number: *

Fax number: *

Vehicle Requirements

Category: *

Other category:

Enter a category if you specified 'other...' in the options above

Body Type: *

Other body type:

Enter a body type if you selected 'other...' in the options above.

Engine size: litres

No. of Cylinders:

Transmission: *

automatic

manual

Fuel Type: *

petrol

diesel

4WD: *

yes

Accessories:

Other accessories:

Enter other accessories if you selected 'other...' in the options above

Preferred make and model:

Period Required

Pick up date: *

Pick-up Place or Delivery Address:: *

Other delivery address:

Return Date: *

extensions available on request

Return Place or Collection Address: *

Other collection address:

Driver Details

Primary Driver Name: *

Licence number: *

Licence class: *

Licence expiry date: *

Phone number: *

Agency Authorisation

Authorising Officer Name: *

Position Title: *

Phone Number: *

Email Address: *

Date of Authorisation: *

Rental Agreement

The Rental Agreement between ExtraCar and your Agency is made up of this Application for Rental of Vehicle and the Terms and Conditions of Rental.

The Terms and Conditions of Rental apply to the use of any vehicle rented from ExtraCar. Please read these details and contact us if you need any further information or explanation. When you enter into a Rental Agreement with ExtraCar, you and the driver(s) of the vehicle will be bound by these terms and conditions, on behalf of your Agency. You must not make an application for rental of a vehicle unless you understand and agree to these terms and conditions. Product Inclusions / Charges A Daily Charge of $66.00 (incl. GST) for small passenger vehicles, $77.00 (incl. GST) for large passenger vehicles and $88.00 (incl. GST) for 4WD and commercial vehicles will apply for the Rental Period. This charge includes fuel, scheduled servicing, NRMA roadside assistance, comprehensive insurance, accident management and free kilometres up to a limit of 200km per day. An excess km charge of $0.20c (incl. GST) per km is applicable at the end of the Rental Period where the total kms travelled exceeds the numbers of days in the Rental Period multiplied by 200kms. Cancellation Policy ExtraCar reserves the right to charge a cancellation fee of $165.00 (incl. GST) if the booking is cancelled within three (3) days of the Pick-up date.

Agreement: *

The Authorising Officer has read, understood and agrees to the Terms and Conditions of Rental

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ExtraCar - Rent a Car Online Form