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
Alfa Romeo, 147, Blue, £5999
Alfa Romeo, 147, Blue, £3499
BMW, 3 Series, Silver, £2699
Chevrolet, Lacetti, Green, £3999
Citroen, C1, Red, £4299
Citroen, C4, Black, £6999
Daihatsu, Sirion, Aluminium/silver, £2499
Fiat, Idea, Orange, £4499
Fiat, Stilo, Brown, £2299
Ford, Focus, Blue, £5999
Ford, Focus, Silver, £4699
Ford, Focus, Green, £2299
Ford, Focus, Blue, £5999
Ford, Galaxy, METTALLIC GREY, £17999
Ford, Mondeo, Blue, £2999
Ford, Ranger, Orange/aluminium/silver, £7499
Ford, Streetka, Grey, £5499
Honda, Civic, Green, £3299
Lexus, IS, Silver, £5999
Mazda, RX8, Black, £10999
Mazda, RX8, Red, £7490
Mercedes-Benz, C Class, Blue, £9999
Mercedes-Benz, R Class, Blue, £19999
Mercedes-Benz, SL Class, White, £11999
MG, TF, Aluminium/silver, £5999
MG, TF, Green, £3699
MG, TF, Blue, £4599
Peugeot, 407, Aluminium/silver, £6999
Renault, Laguna, Grey, £3299
Renault, Megane, Blue, £8499
Rover, 25, Grey, £1999
Saab, 9-3, Black, £3499
Saab, 9-3, Silver, £3699
Saab, 9-3, Silver, £7999
Skoda, Superb, Blue, £5499
Suzuki, Swift, METALLIC RED, £5999
Toyota, Avensis, Black, £6999
Toyota, Celica, Grey/blue, £8499
Toyota, Yaris, Black, £7999
Vauxhall, Astra, Black, £7499
Vauxhall, Corsa, Red, £4499
Vauxhall, Omega, Blue, £2999
Vauxhall, Tigra, Silver, £7999
Vauxhall, VXR8, Black, £18999
Volkswagen, Golf, Blue, £4299
Volvo, 960, Green, £999
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
