Company Proposal

If you are an agent of CS Vehicle Funding or a dealer completing this form on behalf of your client, please complete your details below:

Agent/Dealer name

Telephone number

Fax number

Company Name

Company Reg No.

Nature of Business

Address 1

Address 2

Town

County

Post Code

Time at Address Years   Months

Premises:  Freehold   Leasehold   Rented

Contact Name

Tel

Tel(Mobile)

Fax

How long in business?

Title Please Choose Mr Mrs Miss Ms Dr Prof

First name

Surname

DOB (dd/mm/yyyy)

Current Home Address

Address 1

Address 2

Town

County

Post Code

Accomodation Status:  Home Owner   Tenant

Home Tel

Email

Time at Address Years   Months

Previous Address (if less than 4 years at current address)

Address 1

Address 2

Town

County

Post Code

Title Please Choose Mr Mrs Miss Ms Dr Prof

First name

Surname

DOB (dd/mm/yyyy)

Current Home Address

Address 1

Address 2

Town

County

Post Code

Accomodation Status:  Home Owner   Tenant

Home Tel

Email

Time at Address Years   Months

Previous Address (if less than 4 years at current address)

Address 1

Address 2

Town

County

Post Code

Has any Director or the Company ever had any of the following registered against them?

County Court Judgement

Payment Default

IVA

Bankruptcy

Name of Bank

Address 1

Address 2

Town

County

Post Code

Time Account Held Years    Months

Account Name (E.G. Mr. A. Smith)

Account No

Sort Code

Annual Mileage

1st Choice

Make:

Model:

Spec:

2nd Choice

Make:

Model:

Spec:

3rd Choice

Make:

Model:

Spec:

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