Leasing Form For Vendor

Contact Name (required)

Contact Number (required)

Email (required)

Company Name (required)

Company Registration Number (required)

Name Of Bank

Name Of Account Holder

Bank Account Number

Car Brand & Model (required)

Engine Displacement (required)

Transmission Type (required)

Car Registration Year (required)

Insurance Company For This Car (required)

Insurance Expiry Date (required)

Rental Price per Day (RM/day)

Rental Price per Day (RM/week)

Rental Price per Day (RM/month)

Pickup Location, (Collect From:)

Return Location, (Return To:)

Additional Message

Attach Images Of The Vehicle