Rossmore Rd East
Ellesmere Port
Wirral
CHESHIRE
CH65 3BR
Tel:
0151 3551800
Fax:
0151 3554900
gleve@btconnect.com
Mon - Sat: 9 `til late
Sun: 11 - 5
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Please fill out the form below to submit an application for car finance :
Customer
Title
Date Of Birth
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January
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October
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December
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02
01
Surname
Marital Status
Married
Single
Widowed
Divorced/Separated
Forenames
E-Mail address
Present Address
Previous Address
(if less than 3 years at present)
Address
Address
Postcode
Postcode
Phone
Time At Address
y
m
Time at this address
y
m
Tenure
Owner
Tenant
Living with Parents
Present Employment
Previous Employment
(if less than 3 years at present)
Occupation
Employment Type
No Previous Employment
Employed
Self Employed
Type
Full Time
Part Time
Temporary
Time With Employer
y
m
Time with employer
y
m
Employer
Employer
Phone
Address
Postcode
Phone
Financial Details
Payment Method
Direct Debit
Standing Order
Payment Book
Sort Code
Bank/Society
Bank
Building Society
Acc No
Time With Bank
y
m
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.
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