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About You
 
Your Name * required
Address: Street
Town/City
County
Postcode
Telephone/Mobile * required
E-mail * required
How long have you lived at this address?
Council Tenant
Private Tenant
Home owner
Date of Birth (dd/mm/yyyy)
Status Married
  Single
  Divorced
  Common-Law
Employment Details  
Current Employer (if self employed - put Self Employed)
Address
 
 
Telephone
Occupation
How long have you been employed?
Net Income (i.e. take home pay) upto £150.00 per week
£151.00 to £200.00 per week
£201.00 to £250.00 per week
over £250.00
Any other income/benefits

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Data Protection Notice 1998

In considering your application we will search your record at a credit reference agency. They will add to your record details of our search and your application and this will be seen by other organisations carrying out later searches. It is important that you give us accurate information. We will check your details with fraud prevention agencies and if you give us false or inaccurate information and we suspect fraud we will record this. We and other organisations may use and search these records to help make decisions about credit and credit related services, for you and members of your household; trace debtors, recover debt, prevent fraud, and to arrange your accounts or insurance policies; check your identity to prevent money laundering unless you furnish us with other satisfactory proof of identity. You have a right, on payment of fee, to receive a copy of the information we hold about you if you apply to us in writing. We may pass on your details to other companies to send information about the product.

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