Easy Giving Application

Please note that checks are paid 30 days after rentals and are only issued when the payment amount equals $25.

Organization Information

Organization Name *

Mailing Address

Street Address *

City

Zip

State

Contact First Name *

Last Name *

Day Phone

EXT

Fax

Email (abc@example.com) *

Number of ID cards for organization employees/members

Insurance Company

Policy Number

Agent Name

Date of Policy Expiration

Agent Phone

EXT

Tax Exempt

If tax exempt, list the vehicle lease exemption number

Easy Giving Plans

See Plans HERE

Special Requests

*indicates required field

American Express is Advantage Rent A Car's Card of Choice.