Finance Application Form

Q. Have you had any problems relating to not getting finance? * (This question must be answered in order for you to proceed with the finance application)

Yes No

Our finance specialists are able to give finance to people who ordinarily wouldn't be able to get it, whether it's because of a bad credit rating or because you are self employed or a member of the armed forces. No matter what your situation we are usually able to help.

The Applicant

Title: *	Miss Mrs Ms Mr
Surname: *
First Name(s): *
Email: *
Marital Status: *	Married Single Divorced Common Law
Date of Birth: *	DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM 01 02 03 04 05 06 07 08 09 10 11 12 YYYY 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992
Address: *
Postcode: *
Telephone Number: *
Mobile Number: *

Accommodation

Occupancy Type: *	Owner Private Tenant Council Tenant Housing Association Parents Other
How long have you lived in your present location?: *	Years 0 1 2 3 4 5 6 7 8 9 10 10+ Months - 0 1 2 3 4 5 6 7 8 9 10 11 12
Postcode: *
Previous address: * (If less than 3 years at present address)
How long did you live in your previous location?: *	Years 0 1 2 3 4 5 6 7 8 9 10 10+ Months - 0 1 2 3 4 5 6 7 8 9 10 11 12

Employment / Income

Take Home Pay: *
	Monthly Weekly
Computerised Wage Slip: *
Current Employer: *
Occupation: *
Employer's Address: *
Telephone Number: *
How long have you worked for this employer?	Years 0 1 2 3 4 5 6 7 8 9 10 10+ Months - 0 1 2 3 4 5 6 7 8 9 10 11 12
Previous Employers: * (If less than 3 years at present address)
Previous Occupation: * (If less than 3 years at present address)
Previous Employer's Address: *
How long did you work for this employer?: *	Years 0 1 2 3 4 5 6 7 8 9 10 10+

Finance Details

Finance Regarding: *	Please select
Term of Finance	Years 0 1 2 3 4 5
Payment Protection: *
Bank Name: *
Period with Bank: *	Years 0 1 2 3 4 5 6 7 8 9 10 10+ Months - 0 1 2 3 4 5 6 7 8 9 10 11 12
Deposit: *	£ Cash/P'EX

Data Protection Notice 1998

In considering your application we will search your record at a credit reference agency. They will add to your record details of our search and your application and this will be seen by other organisations carrying out later searches. It is important that you give us accurate information. We will check your details with fraud prevention agencies and if you give us false or inaccurate information and we suspect fraud we will record this. We and other organisations may use and search these records to help make decisions about credit and credit related services, for you and members of your household; trace debtors, recover debt, prevent fraud, and to arrange your accounts or insurance policies; check your identity to prevent money laundering unless you furnish us with other satisfactory proof of identity. You have a right, on payment of fee, to receive a copy of the information we hold about you if you apply to us in writing. We may pass on your details to other companies to send information about the product.

Agree

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