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CAR RENTAL INFORMATION

*Type of car :

Proton Wira Proton Perdana Proton Gen 2 Mercedes Van

*Car Transmission :

Manual Automatic

*Type of Rental :

Daily Use Weekly Use

*Pick-up Location :

(e.g Hotel Name)

*Pick-up Date :

*Pick-up Time :

am pm

*Return Date :

*Return Time :

am pm

GUEST INFORMATION

*First Name :

*Address :

Nationality :

*City :

*State/Province :

* Postal Code :

*Contact No :

Fax No :

*Valid Email :

*Reconfirm your Email :

Special Requests :

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