Credit Card Authorization – LA Film Rentals

Do you currently Have Production Insurance?

Annual Insurance
Short Term Insurance
No Insurance

***STOP***

Unfortunately, we do not accept short term insurance directly. Please rent from us on our partner, ShareGrid. You can search on our profile for the same items available on our website.

***STOP***

Unfortunately, we require production insurance for all rentals. Please rent from us on our partner, ShareGrid and you can secure insurance at checkout. You can search on our profile for the same items available on our website.

Production Name

Renters Name *

First

Last

Renters Email Address *

Renters Phone # *

Credit Card # *

Expiration Date *

CCID *

3 or 4 Digits on Front or back of card

Billing Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Front of Card Image Upload

Click or drag a file to this area to upload.

Back of Card Image Upload

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I agree to use this card for rental and/or deposit

I Agree

Signature