CLIENT ONBOARDING

Next Steps

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Thank you for your interest in working with Zeeba. This form is used to collect information about potential clients and is for internal use only. The information you provide will be kept confidential and privileged. Please provide the following information as completely and accurately as possible.

Your First Name *

Your Last Name *

Your Email Address *

Your Phone Number / Business Phone *

Company Name / Legal Business Name *

Business Entity (LLC, LLP, Corporation, Sole Proprietor, Other)

Industry *

Company EIN/Social Security Number *

Year Business Established *

Previous Annual Business Revenue

Business Physical Address *

Address Line 2

City *

State *

Zip Code *

Business Billing Address *

Address Line 2

City *

State *

Zip Code *

Company Size (including owner/Principal) *

US DOT number

What type of vehicle are you looking for? *

Delivery Address (if different than physical address)

Personal Guarantor First Name *

Personal Guarantor Last Name *

Business Reference First Name

Business Reference Last Name

Business Reference Email Address

Business Reference Phone Number

Are you interested in learning more about our Vehicle Damage Coverage? *

Who is the Business Development Representative helping you? *

Item 1: Please Upload Your Photo of Driver's License (Front & Back, JPG format) *

Upload File

Max file size 10MB.

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fileuploaded.jpg

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Item 2: If you have a COI or Proof of Liability, upload here.

Upload File

Max file size 10MB.

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fileuploaded.jpg

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Terms. Please Make an Election Below With "Yes" or "no"By Responding "YES", The Applicant Consents To The Collection, Use, And Disclosure Of The Applicant’s Personal Information By Zeeba Automotive, From Time To Time, For The Purpose Of Determining The Applicant's Creditworthiness For The Rental Of Motor Vehicles. By Submitting This Form, The Applicant Represents That All Statements Above Are True And Correct. Applicant Hereby Authorizes Verification Of References And Facts, Including But Not Limited To Personal References. The Applicant Authorizes The Verification Of The Information Contained In This Application And Information Obtained From Personal References. The Applicant Is Hereby Notified That A Consumer Report Containing Credit And/Or Personal Information May Be Referred To In Connection With This Rental. This Application Is Not A Rental Or Lease Agreement. If This Application Is Not Accepted, Any Deposit Submitted By The Applicant Shall Be Returned.*

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