Rental Customer Account Information Submission

Please use the following form to submit information about your rental customers. Please complete submission form by filling in all relevant form fields. Be assured that the information you submit is kept secure and confidential.

*Required


Customer Information

*Customer Name:

*Address, City & State:

*Zip:

Physical Address, City & State (if different):

Zip:

*Type of Business:

*Year Started::

*Product or Service Provided:

*USDOT#:

*Federal ID#:

Business Information

*Business Owner Name:

*Business Classification:

*Business Website:

Corporate Address, City & State (if different from local address):

Zip:


Primary Contact

*Contact Name:

*Office Phone:

*Cell Phone:

*Email:

*Preferred Method of Contact:

Secondary Contact

*Contact Name:

*Office Phone:

*Cell Phone:

*Email:

*Preferred Method of Contact:


Vehicle Information

*Type of Vehicles Renting:
12 Passenger Transit VanCargo Van 3/4 Ton24 Ft Box TruckDump Truck24 Ft Stake TruckTandem Axle TractorTandem Axle Tractor with Sleeper

*Projected Frequency:

*Does customer own their own trucks?
YesNo

If yes, what type of units:

*Does customer provide company take home vehicles?
YesNo

*Any chance for service maintenance work?
YesNo

*Potential for lease or sale of units?
YesNo

*How did you acquire this customer?
Cold CallReferralRental HistoryReservation CenterCall-InOther

If other, please explain:

*If existing customer, what year did they start doing business with us?

*Requested rate plan for this customer?


Sales Representative Information

*First Name:

*Email:

Need a Truck or Van?

Make your reservation online, or contact us today.

Locally Owned and Operated by Sternberg Automotive Group since 1952

Sternberg Automotive Group has been providing superior service to southern Indiana since 1952. Our group provides services for just about every facet of the transportation industry! Cars, Trucks, Leasing, Rental, Parts, Vehicle Repair, Equipment, Collision Repair — you name it, we have it!