LOW-CAR-CREDIT LTD

	PERSONAL INFORMATION
Surname:
First Name(s):
Your Email:
Date of Birth:	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 day /  January (1) February (2) March (3) April (4) May (5) June (6) July (7) August (8) September (9) October (10) November (11) December (12) month / year (xxxx)
No. Dependent Children:
Marital Status:	Married Single Divorced Separated Living with Partner
	CURRENT ADDRESS
House & Street:
Town:
City:
Post Code:
Mobile Number:
Telephone Number:
Time At Address:
Living Arrangement Status:	Home Owner Council Tennant Private Tennant Housing Assc Living With Partner Living with Parnets Other
	PREVIOUS ADDRESS (if Living at Current Address 3 or less Years)
House & Street:
Town:
City:
Post Code:
Time At Address:
	CURRENT OCCUPATION
Occupation:
Company Name:
Address:
City:
Telephone Number:
Time At Employer:
Frequency of pay (weekly, fortnightly, monthly):
Net pay (Actual money you get):
	PREVIOUS OCCUPATION (If working in Current employment for 3 or Less Years)
Company Name:
Occupation:
Address:
City:
Time At Employer:
	BANK DETAILS
Bank Name:
Account Type (Current, Savings, ect):
Time with Bank:
Cards Held:	Visa Card Master card Debit Card Store Card
	SPOUSE APPLICATION  FOR JOINT ACCOUNT: Leave Blank if Application is a Personal Application
	PERSONAL INFORMATION
Surname:
First Name(s):
Date of Birth:	day (xx) / month (xx) / year (xxxx)
No. Dependent Children:
Marital Status:
	CURRENT ADDRESS
House & Street:
Town:
City:
Post Code:
Telephone Number:
Time At Address:
Living Arrangement Status:
	PREVIOUS ADDRESS (if Living at Current Address 3 or less Years)
House & Street:
Town:
City:
Post Code:
Time At Address:
	CURRENT OCCUPATION
Occupation:
Company Name:
Address:
City:
Telephone Number:
Time At Employer:
Frequency of pay (weekly, fortnightly, monthly):
Net pay (Actual money you get):
	LOAN REQUIREMENTS
	Please give details of How much loan you require, and details of any part exchange cars you would like to put as deposits, or any deposit you may require.
Details of Loan Required:

The information that you have provided on this form may be passed on to one or more lenders, who may conduct a search of your record held with one or more credit reference agencies  Because you make this application through a licensed credit broker, credit checks may appear on your credit file lodged by organisations with whom you have not dealt with directly. These agencies will record details of these searches which may be seen by other lenders when assessing applications from you and members of your household in the future. Lenders will cross check information with other Lenders to prevent fraud and may also use this information for statistical, marketing purposes and debt tracing.  You have the right to receiver a copy of the information a Lender/Agency holds about you if you apply to them in writing and pay a fee.  It is important that the information you give in connection with this application is true, accurate and is a full disclosure of all relevant information.  Clicking SUBMIT confirms that your details on this application are correct and consent to the use of your information for the above purposes.  Your details will be stored for marketing purposes.  If you do not wish us to contact you, please advise us in writing or via email to sales@low-car-credit.com. Calls may be recorded for training purposes.