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KC Websites has provided Soualiga Car Rental this secure server. An extra level of encryption is added to all communications between you and this secure server by Comodo. Clicking the Comodo logo will confirm that the encryption is in use and the certificate is valid.

Please fill in all fields except secondary driver, if not needed.

RENTER INFORMATION
Name
Confirmation Number
Email Address
Street Address
City
State/Province
Postal Code
Country

PRIMARY DRIVER INFORMATION
Driver's License number
Issuing state
Birth date
Date issued
Expiration date

SECONDARY DRIVER INFORMATION
Name
Driver's License number
Issuing state
Birth date
Date issued
Expiration date

RENTAL CAR INFORMATION
Type of car
Rental period from:
to:         
Collision Insurance YES, I accept the collision insurance as in the price list
NO, I decline the collision insurance

Liability Insurance YES, I accept the liability insurance as in the price list
NO, I decline the liability insurance


CREDIT CARD INFORMATION
Type of credit card
Card Number
(no spaces, please)
Expiration date
MMYY (no space)

    After you submit the information,
    a copy of your confirmation form will appear.
    Please print a copy for your records.