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Introducer Details
Company Name
Ref No.
Contact Name
Tel No.
Fax No.
Customer Details
Company Name
Reg No.
Trading As
VAT No.
Address
Tel No.
Contact
Years Trading
Type of Business
Equipment Details
Description
Term
Value £
Profile
Supplier Name
Supplier Tel No.
Supplier Address
Supplier Fax
Supplier Reg No.
Director/Partner Details - Please read statement below
Director/Partner 1
Director/Partner 2
Name
Address
Property Value
Mortgage Amount
Date Of Birth (dd/mm/yyyy)
Guarantee Available?
Yes
No
Yes
No
Charge Available?
Yes
No
Yes
No
Notes:
We have informed the individuals stated above that:
Searches at one or more of the credit reference agency(ies) will be made against them and recorded by the agency(ies).
Proposal details may be checked with a fraud prevention agency and if false or inaccurate information has been given and fraud is suspected, this will be recorded.
General Asset Management Ltd may use this information to help make credit decisions; trace debtors; prevent fraud; and to check the applicant's identity to prevent money laundering.
The applicant and the individuals have the right to receive a copy of the information that General Asset Management Ltd is holding about them by applying in writing and paying a fee.
Credit scoring may be used in the decision making process.
General Asset Management Ltd may contact the individuals stated above for verification purposes.
General Asset Management Ltd will add to the applicant(s) record with the credit reference agencies details of any finance agreement entered into with the applicant and details of the conduct of the finance agreement, including default or failure to keep to its terms.
We confirm that the individuals stated above have given their consent to the above (please tick).
Declaration
We confirm that all the details contained herein are true and accurate to the best of our knowledge.
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