London Surrey Finance

 
Proposal Forms
 
Dealer's Name
Contact Name
Address
 
 
 
Postcode
Telephone
Fax
Email
Date
Customer information  
Title Mr Mrs Miss
First Name
Surname
Address
 
 
 
Postcode
Period at this address Years/months
Telephone
Mobile
Date of Birth
Marital status Married Single Separated Divorced Widowed
Common Law
Are you ... Owner With Parents Council Tenant Private Tenant
Co-habiting Lodger
Previous address, if less than four years at present address shown above (if more than one address, please provide details of all other addresses separately).
Address
 
 
 
Postcode
Period at this address Years/months
Address
 
 
 
Postcode
Period at this address Years/months
Occupation
Employer's name
Address
 
 
 
Postcode
Telephone
Time in current employment Years/months
Employment status Employed Self employed Full time Part time
Paid Monthly Weekly
Paid by Cash Cheque Transfer
Wages Slips Yes No
Computerised Yes No
Previous occupation
Address
 
 
 
Postcode
Period of employment Years/months
Bank Details  
Bank
Address
 
 
Postcode
Account name
Account number
Sort code
Period with bank Years/months
Driving licence
Address on Licence (if other than present)
 
 
 
Postcode
   
ADDITIONAL INFORMATION
FINANCIAL DETAILS    
Cash Price of Goods   £
VAT £  
Non VAT extras £  
Total Price of Goods   £
Trade in £  
Cash £  
Total Deposit   £
Advance   £
Period Months Rate % Installment £
Payment protection Yes No Installment quoted £
EXISTING CAR FINANCES
Finance company  
Allowance £  
Agreement number  
Settlement £  
Part Exchange Yes No  
THE GOODS New Used   Import Yes No Petrol Diesel
Make
Model
C.C.
Number of doors
Car body type Saloon Hatchback Coupe Estate MPV
Car type Manual Automatic
Registration number
Exact mileage
Date of Registration
Colour
Extras
DATA PROTECTION

The information that you have provided on this form will be disclosed to lenders for the purpose of considering your credit application. Lenders may use this information to carry out searches with credit references agencies. A record of those searches will be kept and may be used by other lenders in assessing applications from you and members of your household for credit in the future. Lenders will also check this information with other lenders to prevent fraud. The dealer completing this form should also tell you of the purpose for which we may use your information.

CUSTOMER DECLARATION
I hereby confirm that all the details given on this form are correct and give my permission for London & Surrey Finance to carry out credit searches.
Customer signature
 
Date
                       

   
  London & Surrey Finance Ltd
2-3 Rectory Lane - Woodmansterne - Banstead - Surrey - SM7 3PP
Tel: 01737 553311 - Fax: 01737 550040-550096 - Email: info@lsmf.co.uk