APPLY NOW - PERSONAL USER
PRINTOUT AND FAX FORM
To enable us to process this proposal ALL sections must be completed.
If you have any difficulty or have a query on any part of this form, please call our HELPLINE: 01792 762230
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Date
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Personal Details
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Full
Name
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Post Code |
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Time
at Address
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Years / Months |
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If less than 3 years at current address | |
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Post Code |
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Date
of Birth
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...  Married Single Other |
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Employment Details
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Occupation
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Employed Self Employed |
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Post Code |
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Tel No.
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Time with Employer
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Years / Months |
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If less than 3 years please give prevous occupation and employer | |
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Previous Occupation
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Previous Employer
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Time with Employer
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Years /
Months |
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Bank Details
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Bank Name
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Branch |
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Time with Bank
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Years / Months |
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Sort Code
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Account No. |
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Goods
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Goods
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New Used Petrol Diesel |
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Full
Make/Model
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CC |
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Type Doors Mileage |
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Registration Number
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Financial Details  Insurance |
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Cash Price
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£ |
Credit Protection Insurance Yes No |
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Extras/Warranty
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£ |
CPI Type |
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VAT (if
applicable)
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£ |
Life
Life/Accident/Sickness/Unemployment |
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RFL
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£ |
Gap Insurance Yes No |
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Total on the Road
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£ |
DATA PROTECTION ACT Disclosure: We have told the above prospective customer/uarantor that a credit agency will be made against the customer/guarantor and recorded by the agency and that the customer/guarantor may receive mailings from you about your services. (We have also told the customer/guarantor how we intend to use the information provided). |
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Part Exchange
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£ |
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Deposit Cash
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£ |
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Settlement
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£ |
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Total
Deposit
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£
inc VAT |
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Balance to Finance
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£ |
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Period
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Monthly Payment |
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% APR % |
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DATA
PROTECTION NOTICE Your Application - To help us to decide whether we should enter into an Agreement we will use: (a) Information that you have given to us (including the information contained in this proposal and your responses) and / or to the Supplier of the Vehicle (“the Supplier”); and (b) Information we have received following enquiries made about you; and (c) Information that we obtain from your performance of any other agreement you have with us, or any of our subsidiary or associated companies (“our Group”) It is important that you give us accurate information. We will check your details with a fraud prevention agency/agencies and if you give us false or inaccurate information and we suspect fraud, we will record this. The enquiries referred to above may include searching any one or more credit reference agencies who will keep a record of our search. Such information will be shared with other lenders and businesses for the purpose of assessing credit and financial services applications made by you and members of your household and also for statistical analysis and market research. If this is a joint application you may be treated as financially linked to the other applicant and your application will be assessed with reference to any “associated” records. When we carry out the credit search the credit reference agencies will link your financial records, each of which will be taken into account in future applications by either of you. This will only cease when one of you successfully files a disassociation at the credit reference agency. You need to be sure you are entitled to disclose any information about the joint applicant and are able to authorise us to carry out a credit search against them. We may also use a credit scoring system. Marketing - The information that we hold about you may also be used by us and/or our Group for the purposes of advising you about our services and products. We may also give this information to Sterling Insurance Group Limited and they may contact you for similar purposes. You may choose not to be contacted for this purpose. 
Please tick this box if you do not wish to receive such information. Please
tick this box if you do not wish your details to be passed to third parties for marketing purposes. Use and Disclosure - (a) If we enter into this Agreement with you, we may disclose information about you, this Agreement and the conduct of your account (including your payment record, any default, or changes of address you failed to tell us about) to (i) any licensed credit reference agency; (ii) HP Information Plc; (iii) tracing/debt collection agencies; (iv) our Group; (v) the Supplier; (vi) Sterling Insurance Group Limited; (vii) any fraud prevention agency. (b) Information supplied will be available to us and other organisations to: (i) help make decisions about credit related services, for you and members of your household; (ii) help make decisions on motor, household, credit, life and other insurance proposals and insurance claims, for you and members of your household; (iii) trace debtors, recover debt, prevent fraud, and to manage your accounts or insurance policies; (iv) check your identity to prevent money laundering, unless you furnish us with other satisfactory proof of identity. (c) We, the credit reference agency/agencies and the fraud prevention agency/agencies will also use the records for statistical analysis about credit, insurance, fraud and market research. Please telephone us on 01792 762230 if you want details of those credit reference agencies and fraud prevention agencies from whom we obtain information and with whom we record information about you. |
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PLEASE FAX BACK TO: 01792 762231