Finance Application Form The Applicant Title:* Miss Mrs Ms Mr Surname:* First Name(s):* Email:* Marital Status:* Married Single Divorced Common Law Date of Birth:*  DD/MM/YYYY Address:* 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 Previous address: (if less than 3years 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 Current Employer:* Occupation:* Employers Name * 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 3yrs at current employer) Previous Occupation: 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:* General Enquiry Audi, A4, Black, £2499 Bentley, Continental, Black, £69999 BMW, 1 Series, Grey, £7699 BMW, Z3, Blue, £4999 BMW, Z4, Grey, £6999 Citroen, Xsara, Mauve/purple/violet, £1699 Fiat, Croma, Blue, £3999 Fiat, Doblo, Grey, £4299 Fiat, Doblo, Blue, £5499 Fiat, Grande Punto, Blue, £3499 Fiat, Stilo, Green, £2499 Ford, Fiesta, SILVER, £1299 Ford, Fiesta, SILVER, £1499 Ford, Mondeo, Blue, £1299 Ford, Mondeo, SILVER, £2699 Ford, Mondeo, Blue, £3999 Honda, Civic, Black, £9699 Jaguar, X-Type, Grey, £4999 Kia, Sportage, SILVER, £12999 Mercedes-Benz, C Class, Aluminium/silver, £699 Mercedes-Benz, SL Class, White, £11999 MG, TF, SILVER, £2299 MG, ZS, SILVER, £1299 Nissan, 350Z, Grey, £12999 Nissan, Almera Tino, SILVER, £2199 Nissan, Primera, Blue, £2499 Peugeot, 1007, Blue, £3499 Peugeot, 206, Red, £3499 Peugeot, 206, Aluminium/silver, £2499 Peugeot, 307, SILVER, £2999 Peugeot, 307, SILVER, £5699 Peugeot, 407, Blue, £5999 Peugeot, 407, Grey, £3999 Renault, Clio, Black, £1499 Renault, Clio, Red, £4699 Renault, Laguna, Grey, £1499 Renault, Megane, SILVER, £1699 Renault, Scenic, Black, £3499 Rover, 400, Red, £999 Rover, 75, SILVER, £1299 Suzuki, Jimny, Grey, £7999 Suzuki, Swift, Red, £4999 Suzuki, Swift, Turquoise, £7499 Toyota, Avensis, SILVER, £3699 Vauxhall, Astra, SILVER, £1499 Vauxhall, Corsa, Red, £11499 Vauxhall, Corsa, Black, £7999 Vauxhall, Vectra, SILVER, £4499 Vauxhall, Zafira, Grey, £1999 Volkswagen, Golf, Black, £1999 Volkswagen, Passat, Blue, £4499 Volkswagen, Passat, Aluminium/silver, £4299 Volvo, C70, Grey, £4499 Volvo, S40, Green, £8999 Volvo, S40, Grey, £7999 Term of Finance:* Years 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. I Agree © Glasshoughton Car Sales