Renter Profile Data Capture Sheet
Personal Detail
Title:
- Choose a title -
Dr.
Ds.
Miss.
Mr.
Mrs.
Ms.
Prof.
Surname:
Full Names:
Identity Number
Passport Number:
Contact Detail
(including dialing code)
Example
:
Landline (Office):
Landline (Home):
Landline (Fax):
Cellular:
E-Mail Address:
Address
Postal Address :
Postal Code:
Residential Address:
Postal Code:
Loyalty Programmes
SAA Voyager No :
Prokard No
Other Programme Name
Other Programme Number
Corporate Affiliation
Company Name :
Part of Group (If any)
Telephone Number
Account Number
Contact Name
Booking Information
How do you reserve your vehicles?
Travel Agent
Corporate
Budget Central Reservations
Internet
Other
How do you settle your account?
Travel Agent Billback
Corporate Billback
Credit Card
Other
What group vehicle do you reserve?
What make do you prefer
What Waivers do you purchase?
Collision damage waiver & theft loss waiver
Super collision damage waiver & super theft loss waiver
Self insured
Do you accept our personal accident insurance?
Yes
No
Would you prefer to be issued with a Budget ID Card?
Yes
No
Kindly send a clear copy of your Identity Document and Driving Licence to: Fax 0866488389 OR Email:
customercare@budget.co.za
