Car of the week

 Midland Cars Supplying Your Prestige Car
                                    Supplying Your Prestige Car
Cars Sold By Midland Cars

 

Your Details
Title:*
First Name(s):*
Surname:*
Email:*
Marital Status:*
Date of Birth:*
Address:*
Telephone Number:*
Mobile Number:
 

Accommodation
Occupancy Type:*
How long have you lived in your present location?*
Previous address:*
(if less than 3years at present address)
How long did you live in your previous location?*

Employment / Income
Take Home Pay:*
 £
Monthly
 Weekly
Computerised Wage Slip:
Current Employer:*
Occupation:*
Employer's Address:*
Telephone Number:*
How long have you worked for this employer?
Previous Employers:*
(if less than 3yrs at current employer)
Previous Occupation:*
 
Previous Employer's Address:*
How long did you work for this employer?

Financial
Term of Finance:*
Payment Protection:*
Bank Name:*
Period With Bank:*
Deposit:
 £ Cash - If you have a car to part Exchange please complete the P/Ex form after completing this finance form.

Q. Have you had any problems relating to not getting finance?*
(This question must be answered in order for you to proceed with the finance application)

Yes No
 

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.

I Agree


Midland House, Claines Garage, Droitwich Road, Worcester. WR3 7SW
Telephone Number : Office 01905 75 57 75  Mobile: 07908 208802
© Midland Cars 2007