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No Deposit or Low Deposit - 12/ 60 Month Repayment - Self-Employed
Tenants - CCJ - Default - Voters Roll Not Essential - Min Age 18
Amount you wish to borrow ?       Loan Length  
Which car are you interested in ?   
Title:
Mr. Mrs Miss Ms
First Name: Surname: Date of Birth:
Marital Status:
Single. Married. Divorced
Separated. Widowed. Common Law.
Previous Surname (if you have changed in the last year):
 
Current Address:
 Home Telephone Number:
Work Telephone Number:
Postcode: Mobile Telephone Number:
 
Length of Time at Current Address:  
Yrs mnths  
Occupancy Type:
Owner. Private Tenant. Council Tenant
Housing Ass'. Parents. Other
If length of time at Current Address is less then 3 years
Previous Address:
Previous Postcode:
   
Employment Status:
Employed Self Employed 		Current Employer:
Employer Address: Length of Time at Current Employer
Yrs mnths
If length of time at Current Employer is less then 3 years
Previous Employer Details:
Take Home Pay: Computerised Payslip:
£   YES NO
   
Have you had any credit problems i.e.: CCJs, Arrears, Defaults, Bankruptcy, IVA etc?
YES NO
If YES, please give details:

Declaration: By Submitting this form I/we hereby accept that a formal credit search may be carried out in my/our name(s) with credit Reference Agencies who will record details of the search and may use such information with other lenders in assessing applications from the applicant(s) or other members of the applicant(s) household for debt recovery, trading debtors and preventing money laundering and fraud.

A written quotation is available on request. Data Protection - the information you have supplied will be used for the purpose for which you have provided it and any relevant procedures following from this. This data will be maintained in accordance with the Act and will not be pressed on or said to any other organisation without your prior approval unless this is a legal requirement.
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