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|Preferred Service Master Rental Agreement |

This form tells us about you. It allows us to hold your personal details, optional insurances and coverages, chosen payment method and car type in our ‘Wizard’ computer system, so we can recognise you when you pick up your car.

Please complete this form which is an application to enrol in Avis’ Preferred service.

It is important you complete all sections on this enrolment form. This is mandatory information in order for Avis to offer you Preferred service.

To complete the fields on the form below (use the 'tab' key or forward/back arrows to jump through the entry fields).Once completed please print and sign it. Fax to the fax number shown at the end of the document.

|Personal details |

| |

|Title | |Employee Number (CCI Field) |      |

|Surname |      |Forename |      |Middle initial |  |

| |

|Please supply both address details below: |

|Company name (if applicable) | |

|Your selected mailing address | |

|Mailing address |      |

|Postcode |      |Country |      |

|Telephone number (business) |      |

|Telephone number (home) |      |

|Telephone number (mobile) |      |

|Email address |      |

| |

|Driver Licence number |      |

|Driver Licence issuing country and/or state |      |

|Date of birth (dd/mm/yy e.g. 240776) |      |

|City of birth |      |

|Country of birth |      |

|Existing Wizard Card number |

If you already have an Avis Wizard number, by completing this form you can upgrade to Preferred service.

|Wizard number (if applicable) |      |

|Avis Worldwide Discount number |

If you already have an Avis Worldwide Discount (or AWD) number, please supply details below.

|Avis Worldwide Discount (AWD) number (if applicable) |     U2290 |

|Company name (if applicable) | |

When you rent on your company’s business the above AWD number will apply. Your company’s AWD number may include certain optional coverages that you are deemed to accept (or decline) in accordance with your company’s contract with Avis.

|Optional insurances / coverages |

It is very important to specify your exact requirements.

Please pre-select any other optional coverages which you may require for Preferred service rentals by selecting either Yes (accept) or No (decline) in all of the five sections below. Please verify your personal insurance requirements at the time of reservation.

|Collision Damage Waiver (Covers accidental damage to the vehicle. Excess may be applicable) | |

|Theft Protection (Europe and Africa only. Covers loss or damage to the vehicle caused by theft. Excess may be | |

|applicable) | |

|Personal Accident Insurance (Covers death or injury to driver and passengers while with the vehicle. Subject to | |

|exclusions and limits) | |

|Personal Effects Protection (Covers loss or damage to personal effects while in the vehicle. Subject to exclusions | |

|and limits) | |

|Additional Liability Insurance (USA only. Motor liability cover up to US$ 1 million for third parties, including | |

|passengers) | |

Additional insurances and waivers may be available as counter products.

|Payment method |

All rentals which you make using Preferred service will be automatically be billed to your Avis central billing account or your selected charge / credit card. Please indicate only one credit card

|Type of card | |other |      |

|Card number |      |Card expiry date (dd/mm/yy e.g. 240706) |      |

|Car type |

|Car group required | |

|Cars shown here are typical European |Car group |Car type |Typical European model |

|models. | | | |

|Please note car groups and models vary by | | | |

|country. In Europe, only selected models | | | |

|of group D upwards have automatic | | | |

|transmission option. | | | |

| |B |Economy |Vauxhall Corsa 1.2 LS |

| |C |Compact 4 door |Vauxhall Astra 1.4 LS |

| |D |Intermediate 4 door |Vauxhall Vectra 1.8 LS |

| |F |Intermediate 5 door |Vauxhall Vectra 2.0 |

| |G |Estate |Vauxhall Astra 1.6 LS |

| |J |Automatic |Peugeot 406 2.0 Estate |

|Frequent traveller |

If you hold a frequent traveller membership you may be entitled to points on qualifying Avis rentals.

Please indicate the programme you wish these to be credited to (select one only)

|Airline / hotel name |      |

|Frequent traveller number |      |

|Acceptance of terms |

I hereby acknowledge that I have read and accepted the Terms and Conditions relating to acceptance of terms. I hereby authorise Avis to charge all costs associated with vehicle rentals by me under Preferred service to the central billing account or charge / credit card nominated herein.

Avis maintains a database of Customer’s details and may from time to time contact you with details of Avis services and offers of other companies which Avis believes may be of interest. Do you wish to receive such information ?

Please now print this Master Rental Agreement and sign below: (scanned or typed signatures cannot be accepted)

|Please fax the signed Master Rental Agreement to: | |

|Signature: | |Date (dd/mm/yy e.g. 240706) |      |

• Due to legal requirements Avis has to receive the original signature in certain markets. Please send the original document to the appropriate address listed below. In order to speed up the process, please fax the application and the card will be issued as soon as the original document arrives by mail.

Belgium

Avis Belgium S.A.

Rue Colonel Bourg 107

B-1140 Brussels

Belgium

Ireland

Avis Ireland

Sales and Marketing Department

Emmet Place

Cork

Ireland

Italy

Avis Autonoleggio SPA

Via Tirburtina 1231

I-00131 Rome

Italy

South Africa

Zeda Car Rental (PTY) Ltd

P.O Box 221

Isando 1600

South Africa

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