Driving and Accident Record Declaration

of Licenses for Applicants in the United

States and Canada
I, ................................................................................................., as part of an application for a Zipcar
membership do declare under penalties of perjury, that I meet the following driving, accident and use
requirements:
I am at least 21 years old (unless joining through a campus affiliate that allows 18+ members)
I have a valid driver license and have been licensed for at least 1 year
I have no history of tickets or violations for operating to endanger, reckless driving or similar
offenses
I have no history of driving under the influence of alcohol or drugs
I have no history of operating a motor vehicle with a suspended or revoked license or leaving the
scene of an accident involving property damage
In addition to complying with all terms of the Zipcar member contract, I certify that I will not use a
Zipcar in the following ways:
The delivery of goods for fee, hire or reward (couriers, parcel delivery services)
The business of transporting people or operating a taxi, cab, car service or similar service
Please note that it is often a mandatory requirement for you to exchange your foreign driving license for a
local license. The timing and conditions of such requirements vary by state/province, but are the sole
responsibility of the applicant/member to understand and adhere to local laws and license requirements.
By signing this agreement, you agree to comply with the law.
Applicants Signature: ............................................................................ Date: ..........................................
Print Applicants Name: ............................................................................
Terms and Conditions:
1) By signing this declaration, you are confirming that you have met all of the above criteria and declare that you are
properly licensed to drive in any jurisdiction in which you will drive.
2) This contract is a legally binding document. You represent that all information and documents submitted by you are
truthful and accurate.
3) Any misrepresentation by you will invalidate your Zipcar membership. In such event, you will not be eligible for any
membership benefits including any applicable insurance coverage, and will be personally liable for the full amount of
any bodily injury, property, or vehicle damage.

Please return this completed form, along with the following documentation to records@zipcar.com:
A copy of your drivers license
A copy of the photo page of your passport (for those licensed in a US territory or Canadian
province, any secondary ID is acceptable)