FINANCE PROPOSAL FORM

Date of Birth

Mr / Mrs / Miss / Ms / Other

Title

.../..../.

Home Phone:

Full Name

Mobile:

Maiden Name if recently married

Email:

Current Address

Marital Status

Residential Status

Married

House Owner

Single

Tennant

Divorced / Separated

Living with Parents

Widowed

Employers Accommodation

Postcode
Time at Address
Electoral Role
Yrs
If less than 3 years please complete previous address

Y / N
If Tennant monthly Rental payment

Are you, your company or any companies in which you hold a majority
shareholding an existing customer of Volkswagen Financial Services UK Ltd?

YES / NO

Previous Address information

Address

Employment Details

Employed

Self Emp. /

Part Time

/ Retired

Occupation
Name of Employer
Postcode

Employers Address

Time at Address
Electoral Role
Yrs
Y / N
If less than 3 years for combined addresses, previous required

Post Code

Time with Employer

Years
If less than 3 years please complete previous employment

Address

Months

Occupation/
Name of Employer
Employers Address
Postcode
Post Code

Time at Address

Yrs

Electoral Role

Y / N

Time with Employer

Years

Months

Bank Details - For monthly direct debit payment

Sort Code
Name of Bank

Account Number

Name on Account

Time with Bank

Years

Customer Declaration
Do you or your company have a majority shareholding interest in one or more companies based in the UK?
Are you a partner of one or more partnerships trading in the UK?
Signature

YES/NO

YES/NO
Date

I confirm that the information I have supplied is Correct and that this loan is affordable given my known levels of income and expenditure.

Balance To Be
Funded

........................

Monthly
Payment

.................................

Balloon Payment
(if applicable)

.............................

Term

(Months)................