FINANCE APPLICATION FORM

For private individuals

Please complete the form below (a copy will be sent to you if you enter your email address) or download the PDF as shown on the left hand side.

You may be asked to provide documents to confirm the details.

* indicates required field




DEALER NAME

Customer Details

Title First Name* Last Name* Maiden name if applicable Status

Number of dependants Date of birth*

Home Address

Home Telephone Number Mobile Telephone Number* Email address Property Type

Residence Type

How long have you lived in the above address?

If less than 3 years give previous address details:

Previous Home Address

How long have you lived in the above address?

BANK/BUILDING SOCIETY DETAILS

Bank Name Branch Sort Code Account Number Account Name Joint Account?

How long with bank

EMPLOYMENT DETAILS



Employer's Name* Occupation* Time with Employer* Annual Salary

Work Address

Employer's Telephone Number

Previous Employer in last 3 years:

Occupation Employer's Name

Previous Work Address

Employer's Telephone Number Time with Previous Employer

FINANCE DETAILS

Total O.T.R Cash Price (inc VAT) Trade In Cash Deposit Total Deposit Balance on Finance Number of Repayments Monthly Repayments

VEHICLE DETAILS

New/Used

Make/Model CC's Colour Car Type

Number of Doors Extras Fuel

Gears

Date first registered Reg Number Mileage VIN/Chassis number


CUSTOMER’S DECLARATION

I hereby declare that the information given above are true in all aspects. I further declare that I have not withheld any information which might prejudice acceptance of this Application. Should my Application be successful I agree to comprehensively insure the vehicle for the duration of the Credit Agreement.

I have read and understood both the Status Disclosure and Use of your Information statements.

Please type your full name below to confirm your signature digitally.

Signature* Date*



STATUS DISCLOSURE STATEMENT
Peninsula Motor Finance can introduce you to one or a limited number of lenders to assist with your purchase, and may receive commission or other benefits for doing so. Neither Peninsula Motor Finance or the lenders can provide independent financial advice.

USE OF YOUR INFORMATION
The information you have provided will be disclosed to Peninsula Motor Finance for the purpose of considering this Application. Peninsula Motor Finance will forward your information to one or more lenders who will carry out searches with Credit Reference Agencies and other regulatory and statutory bodies. A record of these searches will be kept and may be used by other lenders in assessing applications from you in the future. Lenders will cross-check this information with other lenders to prevent fraud and may use it for statistical or marketing purposes. Lenders may use credit scoring as part of their decision making process. Peninsula Motor Finance is a trading name of Peninsula Asset Finance Ltd – Registered in England and Wales: 06453262