Please answer a questions in the following form and send it to sl_rent_a_car@mail.ru
This information is confidential and it is not to be made public
1. Your name (if Your surname changed, write previous):____________________________________
__________________________________________________________________________________
2. Date and place of birth:___________________________________________________________
3. Passport (number, date and place of issue):___________________________________________
__________________________________________________________________________________
4. Adress of registration:________________________________________________________________
5. Actual residence:___________________________________________________
6. Contact phone numbers (with an area code):___________________________________________________________
7. Place of employment (position, adress, phone number): __________________________________________
__________________________________________________________________________________
8.Marital status (Number of marriage years):__________________________________________
9. Name of spouse:_____________________________________________________________
10. Date and place of birth:__________________________________________________________
11. Adress of registration:________________________________________________________________
12. Actual residence:___________________________________________________
13. Contact phone numbers (with area code):___________________________________________________________
14. Place of employment (position, adress, phone number): __________________________________________
__________________________________________________________________________________
15. Children (Name, date of birth):____________________________________________________
__________________________________________________________________________________
16. Parents (Name, adress of residence, contact phone number):___________________
__________________________________________________________________________________
17. Reason of rent:___________________________________________
18. Area of prospective using:___________________________
19. Driver's licence (date of issue, number):__________________________
20. Do You have Your own car?:_____________________________________________
21. Official car owner:_________________________________________________________
22. Brand of the car:_______________________________________________________________
23. License plate number/year of construction :_______________________________________________
24. Estate property (if You have, specificate):
а) apartments/adress__________________________________________________________________
б) house/adress_______________________________________________________________________
в) other/adress______________________________________________________________________
25. Pernicious habits (if You have, specificate):_________________________________________________
26. Do You smoke in cars?______________________________________________________
27. Do You have previous convictions?________________________________________________________
28. Do You take chronic medicine? (If - yes, specificate):___________________
29. Do You have bank account? (if - yes, specificate)______________________________________________
30. Write Your hobby:________________________________________________
31. Where and how do You prefer to relax/travel?_____________________________________________
32. From what source did You know about suggested service?_____________________________________________
Thank You for Your trust, "Izumrudnyi Bereg" Co Ltd
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