Travel and tourism agency

Name and First name:

Son of:

and

Date of birth:                                        

at

Profession:

Address:

N° of telephone:

N° of driver's license:

Delivered in the:

by:

Type of car rented:

Number of enrollment:

Number of the meter:

Date of departure:

to:

Date of arrival:

to:

Direction of:                                           

to:

Is not allowed to leave the country

                 This act is delivrée  to serve and to be worth that that of right.

The original gray card remains by the agency and his/her/its photocopy will be given to the person tenant.

Guelma in the: