www.jcrcorp.com

JCR CORPORATION
Japan Cell Phone Rentals
 Fax. (USA) 1.808.947.3210 

ON-LINE ORDERS

Print the following form (File/Print) and send it via facsimile.  Return confirmation will be sent by E-mail or facsimile.
JAPAN Phone Rental Order Form
Reservation Date: (m/d/y): _____/_____/_____

 CUSTOMER INFORMATION
Customer Name ( F/MI/L): _________________________________________________________________
Home Address:  ________________________________________________________________________  

City: _________________________________       State/Prov. _____________________________                   
Zip/Postal Code: _____________________      Country: _____________________                               
Home Phone: (______)______-____________  Bus. Phone: (______)______-____________ 
Fax Number: (______)______-____________     E-mail Address: ____________________________________
SSN# or Passport#: _____________________________   Country: ___________________________________
Business Name (if corporate credit card): ________________________________________________________
Address: _________________________________________________________________________________________________

 DELIVERY INFORMATION

Hotel / Business:__________________________________________________________
Contact Name (if Different):______________________________________________________________________
Delivery Address:______________________________________________________________________
City: ___________________________________  Prefecture: ___________________________  Postal Code: _________________
Phone: (_______)______-____________             Fax: (_______)______-____________
Special Requests: __________________________________________________________________________________________

 RENTAL INFORMATION
    RENTAL DATE (m/d/y): _____ /_____ / _____   RETURN DATE (m/d/y): _____ /_____ / _____ 
SELECT DELIVERY TYPE  
  FREE Regular Delivery Service (allow 36 - 48 hrs.)
  Japan Same Day Messenger Service ($22.50)  
  Japan Airport Pickup Delivery Service (Narita, Kansai, or Nagoya International Airports $10.00)
          Airline: ________________________    Flt. No. ___________   Arrival Time: ______:______   am   pm
    U.S.A. 2nd Day Delivery via UPS  (Deliveries in the U.S.A. must be returned to our U.S.A. office)
SELECT RETURN DELIVERY
  JAPAN FREE Return Delivery
  Airport Return Delivery Service (Narita, Kansai or Nagoya International Airports $10.00)
   U.S.A. Return
SELECT RENTAL PLAN
   OPTION A Rate Plan : Internal Timer / Direct International Call Access 
   OPTION B Rate Plan : Detailed Billing  / Free Incoming Calls / Direct International Call Access
   OPTION C Rate Plan : Email / Internet Access Phone (I-mode Service)
  Phones Requested  _______
MOBILE WIRELESS INTERNETS SERVICE 
  32K Air-H Wireless Mobile Card    128K Air-H Wireless Mobile Card   Rapira Wireless Mobile Card  
    Mobile Triplex Card      USB Cable (Win98 Only) 
  JCR-i Temporary Internet Service in Japan  (User Name and Password Provided)
 PAYMENT INFORMATION
Method of Payment:
VISA
MASTERCARD  
AMERICAN EXPRESS
JCB
Select Card Type:
PERSONAL
CORPORATE  
BANK DEBIT
Credit Card Number:
                               
Expiration Date: 
    

  20
   
Expiration Date must exceed  two months past the return date.
Credit Card Billing Address:      Business Address     Home Address
How did you find us ? _________________________________ Search Engine: _____________________________
Agent: _____________________________________

 AGREEMENT
JAPAN CELL PHONE RENTALS and the customer ("Customer") whose name and signature appear on this agreement agree as follows:
The customer signing below authorizes JCR Corporation d.b.a. Japan Cell Phone Rentals (JCR) to process a credit card voucher in customer’s name for all charges and fees incurred from the rental of cellular equipment. The Customer agrees that all information submitted is true and complete. Title and ownership cellular phone equipment and accessories shall remain at all times in JCR Corporation and you agree that you will not attempt to give away, sell, mortgage, assign, dispose of or encumber said equipment nor will you in any manner impair or permit to be impaired our title to and ownership of said equipment.
Customer agrees to purchase the loss/damage waiver protection which covers equipment from loss, theft or damage. Customer agrees that he is responsible for the first $100.00 (deductible) of costs from equipment loss, theft or damage per phone rented.  All equipment and items included with rental must be returned and in original condition.
Japan Cell Phone Rentals may add and Customer agrees to pay a Late Charge equal to 1.5% per month (18% per annum) on past due account balances.
 
CANCELLATION, NO SHOW, LATE ARRIVAL and REFUND POLICIES: Customer agrees there will be no cancellation charge if cellular equipment rental order is cancelled with Japan Cell Phone Rentals 72 hours prior to rental date and Customer and you will not incur any charges. Customer agrees that if cancellation notice with Japan Cell Phone Rentals is not received 72 hours prior to the rental date,  the Customer was not at the delivery address, or has been determined to be a "No Show": a three days' rental cancellation charge plus applicable tax will be billed to the Customer's credit card.  Cellular equipment rental orders received within 72 hours of the date of rental will not be charged for cancellation if the notice is received prior to the shipment of ordered cellular equipment. The cancellation charge will be waived in cases of equipment not delivered on promised date, upon verification and documentation to Japan Cell Phone Rentals.  Phones not returned by Customer on agreed on return date will automatically renewed from day to day until receipt of cancellation notice or return of equipment.
The Customer represents he has read, understands, and agrees with all conditions set forth herein. This agreement shall be in effect when signed by Customer and accepted by Japan Cell Phone Rentals.  Customer shall pay to Japan Cell Phone Rentals all costs and expenses including attorney's fees, court costs and collection agency fees incurred by Japan Cell Phone Rentals in exercising any of its rights or remedies hereunder or enforcing any of the terms, condition or provisions hereof. All information provided here will be kept in strict confidence and shall not be distributed to any other source. Rates as of 11/01/99: Prices subject to change

Limitations of Liability:  JCR shall not be liable to Customer for interruptions of service, loss of data, interceptions of cellular transmission, omissions or errors of third parties, equipment failures, acts of god, strikes, government actions, or causes beyond JCR's reasonable control.  JCR shall not be liable if changes in operations, procedures, or services require modification or alteration of customer's equipment or render customer's equipment obsolete.  there shall be no reductions, setoffs, or credits against the charges for service for downtime or interruption of service unless such period exceeds twenty-four (24) consecutive hours from the time of notice of interruption until service restoration is provided to customer.  if service interruption exceeds twenty-four (24) consecutive hours, JCR shall provide customer with a credit allowance equal to the amount payable by customer during the service interruption period, provided customer promptly notified JCR of the service interruption.  JCR shall give no credit for circumstances caused by the negligence or intentional acts or willful misconduct of the customer.  in no event shall JCR be liable to customer for incidental, consequential or punitive damages, including, but not limited to, lost profits, loss of use, or loss of business opportunity.  JCR shall not be liable for injury to customer, other persons, or property damage through the use of any equipment or service provided under this agreement

Credit Verification, Deposit Requirement, Temporary Service:  Based upon information supplied by Customer, JCR will obtain credit information regarding Customer from trade references and credit reporting agencies.  Based on this information, and other information obtained by JCR, JCR may require Customer to make deposit with JCR.  JCR reserves the right to either refund the deposit if Customer has maintained the account in good standing, or apply the deposit to any balance owed by Customer to JCR.  If JCR refunds the deposit to Customer, said deposit will be sent to Customer by United States first class mail to Customer's last known address.  JCR may require that any such deposit be increased based on Customer's usage or changes in Customer's credit status, or any other valid reason.  At JCR's sole discretion, Customer may receive Service prior to credit review without waiving JCR's right to demand security deposit from Customer.

Access and Telephone Number:  Network access is provided by NTT DoCoMo (Japan) by means of an eleven (11) digit telephone number.  The telephone number is at all times the property of NTT DoCoMo, and the Customer has no interest in, or claim of right to, the telephone number.  JCR reserves the right to change the telephone number upon two (2) days prior notice, except that in the event of suspected fraud, no notice is required.  A cellular telephone number issued by JCR to Customer under this agreement may not be assigned to, or associate with, another cellular telephone except with the consent of JCR.  If Customer assigns or associates the cellular telephone number to another cellular telephone without JCR's consent, Customer shall be responsible for all to said telephone number.

customer indemnity:  CUSTOMER AGREES TO INDEMNIFY, HOLD HARMLESS, AND DEFEND JCR AGAINST ANY CLAIMS RELATED TO CUSTOMER’S MISUSE OF SERVICE OR EQUIPMENT UNDER THIS AGREEMENT.  CUSTOMER AGREES TO REIMBURSE JCR FOR ANY AND ALL COSTS AND REASONABLE ATTORNEYS FEES INCURRED BY JCR IN DEFENDING ANY CLAIMS RELATING TO CUSTOMER’S MISUSE OF SERVICE OR EQUIPMENT.

CAUTION:  Option A airtime minutes are calculated using the phones internal timer.  Tampering with or resetting the timer will can be easily determined by our office upon return of the cellular equipment.  Customers using Option A who misuse  the equipment in this manner will be contacted, automatically be billed with the Option B rates (detailed billing), and will no longer be eligible to rent from JCR.  In addition, there will be a RESET CHARGE of $100.00.
 I have read and understand all rental policies above and those posted on JCR's web pages.

 

  Customer Signature  X ____________________________________________________   Date____________________

 
USA Fax:   1- 808 - 947- 3210
Japan Fax:  03-5701-9400

 

JCR respects your privacy. All information you submit to us is kept entirely confidential and is not shared with anyone outside our organization.