RENT TO OWN APPLICATION - Brains Car Rentals

Welcome to the Brains Car Rentals Management and Services Agency Rent-to-Own Program. This program is designed to give qualified renters the opportunity to transition from short-term rentals into long-term vehicle ownership under clear and structured terms.Before completing the form below, please carefully read the following requirements and conditions:
To qualify, you must have rented with us consistently for at least 5–6 consecutive weeks without payment lapses, police incidents, or unresolved violations.
Your record of on-time payments will be reviewed. Missed or delayed payments may disqualify you.
You must secure and maintain verifiable personal full-coverage insurance before entering the program.
Once eligibility is confirmed, our adjuster will provide the official vehicle valuation. You will need to review and agree to this valuE.
After acceptance, the Rent-to-Own contract will be emailed to you for digital signature and must be returned promptly to complete enrollment.
This program is built to reward consistent customers with the opportunity for ownership, while ensuring fairness, transparency, and accountability. Please ensure that the information you provide below is accurate and complete, as it will be used to process your eligibility and finalize your Rent-to-Own agreement.

I have read and understood the above requirements, and I meet all conditions to proceed with submitting my application.

Date Field*

Date Field

PERSONAL INFORMATION

Complete Legal Names*

Contact Number*

Your Email*

Full Current Address*

Emergency Contact Person*

Emergecy Contact Number*

I, the undersigned, hereby certify that all the information provided above is true, complete, and accurate to the best of my knowledge. I understand that any false or misleading information may result in denial or termination of my Rent-to-Own eligibility.

DRIVER LICENSE INFORMATION

Driver License No.*

State Issued*

Date Issued*

Date Issued

Expiration Date*

Expiration Date

I, the undersigned, hereby certify that all the information provided above is true, complete, and accurate to the best of my knowledge. I understand that any false or misleading information may result in denial or termination of my Rent-to-Own eligibility.

PERSONAL INSURANCE INFORMATION

Insurance Provider*

Policy Number*

Coverage Type (Must be Full Coverage)*

Insurance Expiration Date*

Insurance Expiration Date

I, the undersigned, hereby certify that all the information provided above is true, complete, and accurate to the best of my knowledge. I understand that any false or misleading information may result in denial or termination of my Rent-to-Own eligibility.

Employment & Income Verification

Employers Name*

Job Title / Type Of Work*

Length of Employment*

Monthly Income Range*

Rental History with Agency

Rental History with Agency (If none, Say NEVER)

Any late payments, tickets, or incidents*

Any unpaid tickets linked to previous rentals*

I, the undersigned, hereby certify that all the information provided above is true, complete, and accurate to the best of my knowledge. I understand that any false or misleading information may result in denial or termination of my Rent-to-Own eligibility.

RTO PREFERRED PAYMENTS

Preferred Payment Method for RTO Program*