Name* IC/Passport Number * Telephone Number * Email* State Origin * Kuala Lumpur Putrajaya Selangor Negeri 9 Melaka Johor Perak P.Pinang Kedah Perlis Kelantan Terengganu Pahang Sarawak Sabah WP. Labuan Vehicle Model * Choose Your Rental Car PERODUA VIVA 850 (M) PERODUA VIVA 1.0 (A) PERODUA AXIA 1.0 (A) PERODUA MYVI 1.3 (A) PROTON SAGA 1.3 (A) PROTON PERSONA 1.6 (A PROTON GEN2 1.6 (A) PROTON INSPIRA 2.0 (A) HONDA CITY 1.5 (A) TOYOTA VIOS 1.5 (A) TOYOTA CAMRY 2.0 (A) PERODUA ALZA 1.5 (A) TOYOTA AVANZA 1.5 (A) TOYOTA INNOVA 2.0 (A) TOYOTA ALPHARD (A) TOYOTA VILLFIRE (A) TOYOTA HIACE VAN 2.5 (M) NISSAN URVAN 3.0 (M) TOYOTA HILUX 2.5 (A) TOYOTA HILUX 2.5(M) Pick Up Date * Pick Up Time * Return Date* Return Time* Pick Up Location* Return Location * Destination * e.g. Kudat, Ranau or Keningau * Notes (If Any)