Asset91 - Finance Brokers
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Welcome to Asset 91 Finance Brokers Contract Hire and Leasing
Business Loan Application
In order for us to produce an accurate quote you must fill in all fields marked with the *.
Business Details
Name: *
Address 1: *
Address 2:
Address 3:
City: *
Post Code: *
Status: *
Sole Trader
Partnership
Limited Company
Company Reg No: * (If Ltd)
Property:
Freehold
Leasehold
Date Established (dd/mm/yyyy):
Type of Business: *
E-mail Address: *
Director Details
First Name: *
Surname: *
Date of Birth: *
Address 1: *
Address 2:
Address 3:
City:
*
Post Code: *
Time at Address: *
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If less than 5 years please supply previous address
s
Previous Address 1: * (if less than 5 yrs)
Previous Address 2:
Previous Address 3:
Previous City: * (if less than 5 yrs)
Previous Post Code: * (if less than 5 yrs)
Time at Address: * (if less than 5 yrs)
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Director Details (2)
First Name :
Surname::
Date of Birth:
Address 1:
Address 2:
Address 3:
City:
Post Code:
Time at Address:
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If less than 5 years please supply previous address
s
Previous Address 1:
Previous Address 2:
Previous Address 3:
Previous City:
Previous Post Code:
Time at Address:
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Purchase Details
New or Used: *
New
Used
Make: *
Model: *
Engine Size:
Registration / Serial No: *
Chassis No:
Date of first Registration / Manufacturer: *
Milage / Hours: *
Imported: *
Yes
No
Extras:
Details of P/X:
Bank Details
Bank Name: *
Branch:
Account No: *
Sort Code: *
For How Long:
Finance Details
Cost Price: *
Less Deposit - Cash: *
Part Exchange:
Balance to Finance: *
Hire Purchase or Lease:
Hire Purchase
Lease
Reply via:
Email
Telephone
Fax
Application:
Supplier: *
Supplier Tel. No: *
Salesman's Name: *
Additional Comments:
