Name: RideShare Solutions
Address: 64 Parramatta Rd, Underwood, QLD, 4127
Telephone: 1300 190 390

Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How long have you been driving uber?*
Have you previously rented a vehicle for ridesharing?*
- Yes
- No
Who have you rented through previously?*
(if there are multiple, then list one per line)
Have you had any at fault accidents in the last 3 years?*
- Yes
- No
How many?*
Have you had any speeding fines or infringements in the last 3 years?
- Yes
- No
How many?*
How long do you wish to rent for?*
In the event of a vehicle accident or damage, are you able to cover the standard insurance excess of $3,500?*
If your answer is NO, alternate options at a lower price are available and can be discussed upon contact.
- Yes
- No
Driver's Licence Front*
Max. file size: 54 MB.
Driver's Licence Back*
Max. file size: 54 MB.
Medicare Card
Max. file size: 54 MB.
Recent Bill Confirming Address
Max. file size: 54 MB.
Privacy Act Consent
Electronic Communications Consent
I have read and accept the Privacy Act and Electronic Communications Consent*
- Confirm
Signature*
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