Renter Information - Black Rock Rentals

Information Needed For Rental

Please provide the following information for your rental. Once we have the following information, we will send you a document to sign for approval of your rental. After the document is signed we will then charge you card for the agreed upon amount. If you have any questions, please contact us.

Please enable JavaScript in your browser to complete this form.

Name

First

Last

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Front of Drivers License

Click or drag a file to this area to upload.

Back of Drivers License

Click or drag a file to this area to upload.

Insurance Provider

Policy Number

Photo Proof of Full Coverage Insurance

Click or drag a file to this area to upload.

Billing and Messaging Approval

I authorize the use of my credit card for the purchase of my rental vehicle and security deposit. Once the rental is returned your security deposit will be returned to the card on file. Your card will not be charged until all rental documents are signed. Learn more in our Terms of Service and Privacy Policy.

Information Needed For Rental

Hawaii

(808) 866-9554

Address

Utah

(435) 770-8213

Address