Bétulo rent a car S.L.

Avda Alfonso XIII, 229
08918 BADALONA
C.I.F. B-53181178

Rent a car or a van

Tel.: 93 383 12 66

AGREEMENT Nº.


Rentee:....................................................................................................
Address:...................................................................................................
City:..........................Tel:..................C.I.F.(Fiscal Identification Code)........
Driver ......................................................................................................
Date and place of birth: .............................................................................
Driving licence number:..................................Kind:..............File.:...............

Vehicle:...............................................Frame No.......................................

Administrative permission:..................................Issued by :..........,,..........

Data of departure:....................................................................................
Date and time:...............................Kms.:...........Foreseen return :..............
Rates:..........................................................Deposit:...............................
Particular conditions:................................................................................

Data on arrival:........................................................................................
Date and time:.......................................Kms.:...........Fuel:........................
Franchise:.................................Materials:................................................

With my signature hereunder, I allow the rentor to charge the total final amount that I owe for this rental, against my bank account in the entity which issued the above mentioned credit card, and the charge note of said entity is deemed to be done.
I have read and declare that I agree with the above as well as with the rest of conditions of this agreement which appear on the back.

x.........................................
Signature and complete name in handwriting by the client

AMEXICO-DINERS-VISA-EUROCARD-OTHERS
CASH----BONUS AGENCY Nº
Bill approved

X...........................

Received

X.........................