PROPOSAL FORM - CONSUMERS

Date: 03/09/10

Lomeshaye Business Village - Turner Road - Nelson - Lancashire - BB9 7DR
Tel:   0845 230 44 66       Fax:   0845 230 44 77

Email:   sales@efllimited.com
PARTICULARS OF HIRER:
Surname: Forename (1): (2):
Email:
CURRENT ADDRESS PREVIOUS ADDRESS (if less than 5 years at current address)
House Name / Number:   House Name / Number:  
Street Name:   Street Name:  
Town:   Town:  
County:   County:  
Post Code:   Post Code:  
Time At Address (yrs):   Time At Address (yrs):  
OCCUPATION BANK DETAILS
Position:   Name:  
Employer Name:   Address:  
Employer Address:   Postcode:  
Postcode:    
Time With Employer:   Account Name:  
Nature of Business:   Account No:
Employer Tel No:   Sort Code:
- -
PERSONAL DETAILS CREDIT CARDS
Date of Birth:   (dd/mm/yy)
Visa   Other   Amex  
Marital Status:  
No of Dependants:   Salary
Residence Status:  
Up to £5,000 £15,000 to £20,000
£5000 to £10,000 £20,000 to £25,000
£10,000 to £15,000 £25,000 plus
Home Tel No:  
 
DATA PROTECTION NOTIFICATION
  1. So that we may assess your application for finance, you agree that we may search the files of any licensed credit reference agency who will keep a record of that search.
  2. If the funder enters into this agreement with you, they will disclose information about you and the conduct of your account at any time to any licensed credit reference agency.  This information may be used by other lenders in assessing applications for finance from you and members of your household and occasionally for fraud prevention and tracing orders.
  3. They may also disclose information about you and your conduct of this agreement at any time to any motor trader, insurance company, vehicle recovery tracing agent, lawyer, law enforcement agency, mailing agency and our parent, associated and subsidiary companies and their respective agents and contractors.
  4. I confirm that the information above is true and accurate: