Washer and Dryer Rental Agreement

Budget Appliance Rental
2701 #101 1st St, Rosenberg, TX 77471
Phone: (832) 578-9623
Email: Tx@budgetappliancerental.com
Website: www.BudgetApplianceRental.com

Equipment Selection

Washer and Dryer Set ($49.95/month)Washer Only ($39.00/month)Dryer Only ($39.00/month)

Pricing Information:

Washer & Dryer Set: $49.95/month + $198.90 initial payment

Single Appliance: $39.00/month + $188.95 initial payment

Initial payment includes: First month rental + $49 setup + $50 pickup fee + $49.95 security deposit

Customer Information

Full Name *

Address *

City *

State *

ZIP Code *

Phone *

Email *

Driver's License Number *

Employment Information

Employer Name *

Employer Phone *

Position/Title *

Monthly Income *

Income Source * Select Income Source Employment Self-Employed Social Security Disability Retirement Other

Delivery Information

Delivery Address (if different from above)

Apartment Complex Name

Floor Level Select Floor Ground Floor 1st Floor 2nd Floor 3rd Floor 4th Floor Other

Gate Code (if gated community)

Payment Information

Primary Credit Card

Name on Card *

Card Number *

Expiration Date *

CVV *

Billing Address *

Backup Credit Card

Name on Card *

Card Number *

Expiration Date *

CVV *

Billing Address *

Terms and Conditions

By signing this agreement, you acknowledge and agree to the following terms:

• Monthly rental payments will be automatically charged to your credit card

• 11-month minimum rental term

• All maintenance and repairs provided at no cost

• Option to purchase after 11 months (Set: $399, Single: $299)

• Early termination requires 30 days notice plus $100 fee

• Late payment fee of $25 after 5 days

• Customer responsible for damage beyond normal wear

• Valid photo ID required before rental begins

• Budget Appliance Rental reserves right to verify employment and income

• Agreement governed by Texas state law

I have read, understood, and agree to all terms and conditions *

I agree that my electronic signature below has the same legal effect as a handwritten signature *

Electronic Signature

Type Your Full Name as Electronic Signature *

Date *

Submit Rental Agreement

By clicking submit, your rental agreement will be emailed to Budget Appliance Rental for processing.