KrossFleet Lease – KrossFleet LLC

Name Insurance Insurance

Name

First

Last

Address:

Full physical address, including zip code

Driver's License Number:

Insurance Information:

Using own insurance
Interested in Commercial Insurance with KrossFleet LLC
On someone else’s policy

Please select all that apply

Insurance Details:

Carrier, Policy #, Insurance Type

Cardholder Name

First

Middle

Last

Credit Card Details

Total Amount

Price: $250.00

Payment Confirmation

I hereby authorize KrossFleet LLC to charge my credit/debit card with the amount above.

KrossFleet LLC vehicle leases are week to week, with payment due up front for the first week, then due the 7th day of the current lease, for the following week. Corporate leases are setup and billed according to their agreement.