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, £4499 Alfa Romeo, 147, Grey, £3699 Alfa Romeo, 156, Silver, £4999 Alfa Romeo, 166, Silver, £1499 Audi, A3, Red, £7999 Audi, A6, Silver, £13999 BMW, 3 Series, Aluminium/silver, £9999 BMW, 3 Series, Green, £1999 BMW, 3 Series, Grey, £7999 Chevrolet, Lacetti, Black, £3999 Chrysler, Crossfire, Grey, £7999 Chrysler, Crossfire, Blue, £7999 Chrysler, Voyager, Silver, £8999 Citroen, Xsara, Red, £999 Daihatsu, Sirion, Aluminium/silver, £1699 Fiat, Punto, Blue, £1699 Fiat, Punto, Red, £1699 Fiat, Seicento, Grey, £1699 Fiat, Stilo, Green, £3499 Fiat, Stilo, Grey, £3499 Ford, Escort, Green, £1499 Ford, Fiesta, Blue, £5499 Ford, Fiesta, Blue, £3999 Ford, Focus, Green, £3699 Ford, Focus, Aluminium/silver, £4999 Ford, Ka, Pink, £2699 Ford, Mondeo, Blue, £5499 Ford, Mondeo, Aluminium/silver, £3499 Honda, Civic, Silver, £8999 Land Rover, Freelander, Green, £3699 Land Rover, Freelander, Black, £2699 Lexus, IS, Silver, £5699 Mazda, Eunos, Blue, £1999 Mazda, RX8, Black, £9999 Mercedes-Benz, C Class, Blue, £8999 Mercedes-Benz, CLK, siilver, £6499 Mercedes-Benz, R Class, Blue, £18999 Mercedes-Benz, S Class, Aluminium/silver, £5999 Mercedes-Benz, SL Class, White, £11999 MG, TF, Yellow, £4499 MG, ZT, Green, £2499 Mini, Cooper S, Grey, £6999 Peugeot, 206, Black, £5299 Peugeot, 206, Black, £6699 Peugeot, 206, Blue, £3999 Peugeot, 307, Black, £4699 Renault, Clio, SILVER, £2999 Renault, Kangoo, Blue, £4999 Renault, Megane, Black, £4999 Renault, Megane, silver, £2999 Rover, 25, Blue, £1599 Rover, 25, Green, £2499 Seat, Ibiza, Blue, £4999 Seat, Leon, Blue, £8999 Toyota, Corolla, Blue, £6999 Toyota, Yaris, Black, £6999 Vauxhall, Astra, Black, £5999 Vauxhall, Astra, Silver, £4999 Vauxhall, Corsa, Black, £4999 Vauxhall, Corsa, Silver, £499 Vauxhall, Corsa, Black, £4299 Vauxhall, Vectra, SIilver, £7999 Volvo, C70, Aluminium/silver, £6999 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