Loan Car Form | Ingham North Harbour

    1. I confirm that the written details on this agreement are correct.

    2. I confirm that I have a valid Driver’s Licence and am not currently disqualified or suspended from driving.

    3. I acknowledge that I may be liable for charges if this loan vehicle is returned late or in different condition than at the time of loaning (in respect of damage incl. wheels and tyres, cleanliness or fuel level).

    4. I agree to NO SMOKING or NO ANIMALS inside the vehicle.

    5. I acknowledge no other person than those listed in this agreement are permitted to drive the vehicle.

    6. The maximum distance travelled cannot exceed 250km.

    7. I agree to pay for any costs incurred whilst the vehicle is in my care, including fines and in the event of an accident for which normal insurance cover is declined. I acknowledge the insurance excess payable is $2,500.

    8. I am aware and acknowledge that this vehicle may have speed and location monitored by GPS.

I (the driver) confirm that I take full responsibility for any penalties for traffic violations that are forthcoming that relate to incidents whilst the vehicle was in my possession.
Click or drag a file to this area to upload.
Please upload a copy of your drivers licence, front and back.