Business application form OLD

Requested Vehicle Details

Vehicle Preference (Make / Model)

Annual Mileage (Please select)

General Details

Contact Name

Company Name

Telephone Number

Fax Number

Email Address

Job Title

Address

Postcode

Business Details

Company Reg No

Nature of Business

Year Est:

VAT Reg No

Property

If property type is other - please state

Fleet Size

Registered Office Address (If Different From Above)

Registered Office Postcode

Accounting Details

Year End

Last Audit

Personal Details (First Director)

Title (First Director)

Full Name (First Director)

Address (First Director)

Postcode (First Director)

Telephone (First Director)

Property - Please select (First Director)

If Other - Please state (First Director)

How long at above address (First Director)

Date of Birth (First Director)

Status - Please select (First Director)

Number of Dependants (First Director)

Address History - If less than 3 years (First Director)

Address

Postcode

Personal Details (Second Director)

Full Name (Second Director)

Title (Second Director)

Address (Second Director)

Postcode (Second Director)

Telephone (Second Director)

Property - Please select (Second Director)

If Other - Please state (Second Director)

How long at above address (Second Director)

Date of Birth (Second Director)

Status - Please select (Second Director)

Number of Dependants (Second Director)

Address History - If less than 3 years (Second Director)

Address

Postcode

DECLARATION DECLARATION I/We declare that the information supplied on the credit proposal is true and correct. I/We authorise the funder to make a credit reference search, which will be recorded by the agency. I/We am/are aware that credit scoring may be used in the decision making process. I/We agree that the funder can, at any time, disclose details about the application, agreement and the conduct of the account to a licensed credit agency, or HP information Plc, or introducing Dealer/Broker for the purposes of: fraud/crime prevention, tracing customers and any other legitimate purpose. I/We also acknowledge that the funder may refuse to enter into this agreement without stating a reason. I/We understand and agree that any personal details contained within this credit application may be passed to any third party as part of the process and that the details provided will not be used for any direct marketing purposes.

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