(DO NOT USE) APPLICATION FORM
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WAITLIST REFUND
ONLINE DEPOSIT
NOT RESPONSIVE
PENDING DOCUMENTS
APPROVED DOCUMENTS
APPROVED BG CHECK
TRANSFER
FOLLOW-UP REQUIRED
DUPLICATE ENTRY
PLATINUM CREDIT
PLATINUM CREDIT (PENDING DOCUMENTS)
ONLINE DEPOSIT (PENDING DOCUMENTS)
ONLINE DEPOSIT (FOLLOW-UP REQUIRED)
PLATINUM CREDIT (FOLLOW-UP REQUIRED)
PENDING FOR PLATINUM CREDIT CHEQUE
PENDING FOR CASH MAX CHEQUE
NO CHEQUE RECEIVED (INVOICE VOIDED)
NEW PROMO GIVEN
Salutation
*
Please Select
MR.
MS.
Full Name
*
NRIC
*
Phone Number
*
Date of Birth
*
-
Day
-
Month
Year
Date Picker Icon
Address
*
Address Line 1
City
*
City
Postal Code
*
Postal Code
E-mail
*
Bank name
Bank account no.
Emergency contact name
*
Emergency contact number
*
What you need to get started
NRIC Verification
*
YES
NO
Driving License Verification
*
YES
NO
Driver Improvement Points (DIPS)
*
Deposit Collection
Contract length
*
5 WEEKS
26 WEEKS (6 MONTHS)
FLEXI-RENT 12 WEEKS
52 WEEKS (1 YEAR)
Deposit amount
*
$100 + $400
$500
$100 + $1,400
$1,500
$200
Vehicle Preference
Age of car
*
LESS THAN 3 YEARS OLD
MORE THAN 3 YEARS OLD
ANY
Preference 1
*
Please Select
OTHER
HONDA ACCORD
HONDA AIRWAVE
HONDA CITY
HONDA CIVIC
HONDA FREED
HONDA GRACE HYBRID
HONDA SHUTTLE
HONDA SHUTTLE HYBRID
HONDA STREAM
HONDA VEZEL
HONDA VEZEL HYBRID
HYUNDAI AVANTE
HYUNDAI ELANTRA
HYUNDAI I30
KIA CERATO
KIA CERATO FORTE
KIA FORTE K3
MAZDA 2
MAZDA 3
MAZDA 6
MITSUBISHI ATTRAGE
MITSUBISHI LANCER
MITSUBISHI LANCER EX
NISSAN ALMERA
NISSAN LATIO
NISSAN SYLPHY
SUZUKI SX4
TOYOTA ALLION
TOYOTA ALTIS
TOYOTA AXIO
TOYOTA AXIO HYBRID
TOYOTA CAMRY
TOYOTA ISIS
TOYOTA PRIUS HYBRID
TOYOTA RUSH
TOYOTA SIENTA
TOYOTA SIENTA HYBRID
TOYOTA VIOS
TOYOTA WISH
VOLKSWAGEN JETTA
If other, please enter:
Preference 2
Please Select
OTHER
HONDA ACCORD
HONDA AIRWAVE
HONDA CITY
HONDA CIVIC
HONDA FREED
HONDA GRACE HYBRID
HONDA SHUTTLE
HONDA SHUTTLE HYBRID
HONDA STREAM
HONDA VEZEL
HONDA VEZEL HYBRID
HYUNDAI AVANTE
HYUNDAI ELANTRA
HYUNDAI I30
KIA CERATO
KIA CERATO FORTE
KIA FORTE K3
MAZDA 2
MAZDA 3
MAZDA 6
MITSUBISHI ATTRAGE
MITSUBISHI LANCER
MITSUBISHI LANCER EX
NISSAN ALMERA
NISSAN LATIO
NISSAN SYLPHY
SUZUKI SX4
TOYOTA ALLION
TOYOTA ALTIS
TOYOTA AXIO
TOYOTA AXIO HYBRID
TOYOTA CAMRY
TOYOTA ISIS
TOYOTA PRIUS HYBRID
TOYOTA RUSH
TOYOTA SIENTA
TOYOTA SIENTA HYBRID
TOYOTA VIOS
TOYOTA WISH
VOLKSWAGEN JETTA
If other, please enter:
Preference 3
Please Select
OTHER
HONDA ACCORD
HONDA AIRWAVE
HONDA CITY
HONDA CIVIC
HONDA FREED
HONDA GRACE HYBRID
HONDA SHUTTLE
HONDA SHUTTLE HYBRID
HONDA STREAM
HONDA VEZEL
HONDA VEZEL HYBRID
HYUNDAI AVANTE
HYUNDAI ELANTRA
HYUNDAI I30
KIA CERATO
KIA CERATO FORTE
KIA FORTE K3
MAZDA 2
MAZDA 3
MAZDA 6
MITSUBISHI ATTRAGE
MITSUBISHI LANCER
MITSUBISHI LANCER EX
NISSAN ALMERA
NISSAN LATIO
NISSAN SYLPHY
SUZUKI SX4
TOYOTA ALLION
TOYOTA ALTIS
TOYOTA AXIO
TOYOTA AXIO HYBRID
TOYOTA CAMRY
TOYOTA ISIS
TOYOTA PRIUS HYBRID
TOYOTA RUSH
TOYOTA SIENTA
TOYOTA SIENTA HYBRID
TOYOTA VIOS
TOYOTA WISH
VOLKSWAGEN JETTA
If other, please enter:
When would you like to collect your vehicle?
*
-
Day
-
Month
Year
Date Picker Icon
Promotions
Promotion
*
TDVL REFERRAL
TDVL NON-REFERRED
TDVL EXISTING NON-REFERRAL
TDVL EXISTING ($224) NON-REFERRAL
TDVL ($224) REFERRAL
TDVL ($224) NON-REFERRAL
REFERRAL (NEW) $500 +NDI
NON-REFERRED (NEW) $500+NDI
$500 OFF
$2600 OFF
REFERRAL (EXISTING) $250/$250
NON-REFERRED (EXISTING) $500
FLASH DEAL SMS REFERRAL (WEF 29-APR-2017)
FLASH DEAL SMS NON-REFERRED (WEF 29-APR-2017)
NOT APPLICABLE
PENDING
REFERRAL (NEW) $200 +NDI
NON-REFERRED (NEW) $200+NDI
$900 OFF(FOR EDIT ONLY)
1 MONTH FREE RENTAL ($2000) (EDIT ONLY)
$800 OFF (FOR EDIT ONLY)
1 MONTH FREE RENTAL ($1750) (FOR EDIT ONLY)
REFERRAL (EDIT ONLY)$500/$500
NONE/ FLEXI-RENT
$2020 OFF
NON REFERRED (EXISTING)$450
1 MONTH FREE RENTAL ($1500) (EDIT ONLY)
Please enter referral details:
Referral Name
*
Referral Phone No.
*
Referral E-mail
*
Referral License Plate
$50 off for return hirer?
*
YES
NO
STD $50 upon checkout?
*
YES
NO
NTUC Link Points
*
5,000
15,000
NONE
Declaration
By clicking YES below, I hereby declare that
the above information given is true to the best of my knowledge
I am not an undischarged bankrupt
I understand that my application is subject to passing LCR's screening criteria
Hirer Declaration
*
YES
Name
*
Date
*
-
Day
-
Month
Year
Date Picker Icon
**Official use only**
Vehicle Plate
Vehicle Model
Collection date
*
-
Day
-
Month
Year
Date Picker Icon
Vehicle Matched By (Input Name)
*
STD $100 cashback (Backend ONLY)
YES
NO
Reservation No.
ZOHO Invoice No.
*
Sales person name
*
Remarks
How did you hear about LCR?
Please Select
WALK-IN
NEWSPAPER
FACEBOOK ADVERTS
FRIENDS AND FAMILY
UBER MARKETING EMAILS / MESSAGES
FORUMS OR FACEBOOK GROUPS
UBER PROMOTER
SPECIAL REQUEST
*
Please Select
NONE
VEHICLE COLOR
BRAND NEW VEHICLE
BRAND NEW VEHICLE & COLOR
SPECIAL REQUEST TI NUMBER
PARTNER UUID
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