Vehicle Credit Application Form

Full Name

Name:		Date of Birth:		Marital Status:
Home Tel No:		Mob Tel No:		Email:

Full Address

Address Line 1:		Address Line 2:		Town/City:
Postcode:		Time At Address:		Type:

Previous Address

Address Line 1:		Address Line 2:		Town/City:
Postcode:		Time At Address:		Type:

Bank Details

Bank Name	Address Line 1:	Address Line 2:
Town/City:	Postcode:
Name On Account:	Account Number:	Sort Code:
Years Held:	Notes:

Employer

Name	Address Line 1:	Address Line 2:
Town/City:	Postcode:	Work Tel:
Occupation:		Years Employed:
If less than 3 years - Previous Employer:

Vehicle

Manufacturer:		Model:		Spec:
Annual Milage:		Initial Deposit:	£ / Months	Balance Of Rentals:	Months
Payment per month:	£	Maintenance:	Yes No
Contract Hire	PCP PCH Other

Credit Cards

Card	Limit	Payments
MasterCard	£	£
Amex	£	£
Visa	£	£
Access	£	£
Other	£	£

Monthly Income

Net Salary:		Other Income:		Partners Salary:
Pension:		Other:

Monthly Outgoings

Mortgage/Rent:		Other Loans:		Utility Bills:
Credit Cards:		Other expenses:		Car Payment:

Trading Company

Name		Address Line 1:	Address Line 2:
Town/City:		Postcode:
Nature Of Business:		VAT No:	Company Reg No:
Company Tel:		Date Established:
Type:	Sole Trader Ltd Partnership
Premises:	Rented Owned

Partner / Director

Name	Address Line 1:	Address Line 2:
Town/City:	Postcode:	Years at address:
Marital Status:
Previous Address if less than 3 years:
Time with company:

Partner / Director

Name	Address Line 1:	Address Line 2:
Town/City:	Postcode:	Years at address:
Marital Status:
Previous Address if less than 3 years:
Time with company:

Your Declaration

I hereby warrant that the information contained in this application is true and accurate and authorize the lender to make all enquiries to verify the information to enable it to consider this application. I understand that the lender reserves the right to decline this application.

We also understand that we accept by signing the details above I/ we are committing to ordering the vehicle as per quotation. If you choose to cancel this vehicle at any point you may have to pay a cancellation fee of up to 10% of the value of vehicle. Some funders may impose fees for breaking terms and conditions; you will be notified by Grosvenor Hall (Group) Limited if this applies to you.

I/We confirm under the Data Protection Act that I/We wish to proceed.

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*Name:
*Email:
Phone: