Finance

The information that you are providing on this form will be disclosed for the purpose of considering this credit application. Lenders may use this information to carry out searches with credit reference agencies.

A record of these searches will be kept and may be used by other lenders in assessing applications from you and members of your household for credit in the future. Lenders will cross-check this information with other lenders to prevent fraud and may use the information for statistical purposes.

The information you provide on this form may be used for marketing purposes by ourselves or other companies.

Customer Details
Title First Name
Surname DOB
Home Tel Mobile Tel
Marital Status
Current Address Time at Address years months
Status (If other please specify)
Postcode
Previous address
(if less than 3 years
at current address)		 Time at Address years months
Postcode
Employment Details
Occupation Address
Employer
(Trading style if self employed)
Tel
Time with Employer years months Postcode
Status Employee
Self Employed
 Permanent
Temporary 		Full Time
Part Time
Previous Employment Details (if less than 3 years in current position)
Occupation Address
Employer
(Trading style if self employed)
Tel
Time with Employer years months Postcode
Status Employee
Self Employed
 Permanent
Temporary 		Full Time
Part Time
Bank Details - Current Account
Bank
Sort Code
Account No.
Email Address

I confirm that I am happy to be contacted by a customer relations adviser to discuss any insurance policies that may suit my needs but which the dealer cannot offer following the introduction of FSA Regulations.

I confirm that the information given by me in connection with this application is true, accurate and represents a full disclosure of all relevent information.

If false or inaccurate information is provided and fraud is identified, details will be passed to fraud prevention agencies to prevent fraud and money laundering. Further details explaining how the information held by fraud prevention agencies may be used can be obtained on request. Please see full details under the terms and conditions.
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