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Sixt Cards - Card Application Form

Name and private address
Salutation *
Title
Name *
Firstname *
Street *
Country
Post Code *
City *
Private phone *
e-mail *
Date of birth *

Company Address
Company name
Contact Number **
Legal form
Managing Director
Street
Post Code
City
Office Phone
e-mail

Driving licence information
No. of driving licence *
Issuing office *
Dated from *

Payment information
Your personal credit card which you expect to use for payment
Credit Card *
Card-No. *
Expiry Date *
The personal data saved by Sixt is used in accordance with the regulations and provisions of the applicable data protection law. Please note: before receiving your Sixt Card we’ll charge off 1 Euro from your Credit Card to check correctness of input data. This amount will be returned to your card during 30 days after charging off!

Comments (e.g. existing SixtExpress No.)

(*) Mandatory fields.

(**) If available.