Application Form

* Required Fields

Mr Mrs Miss Ms Other

Title*

Full Name*

Current Address*

Owner Tenant LWP

Postcode*

Residential Status*

Time at  Address

Yrs

Months

Previous Address (if less than 5yrs)

Postcode

Time at Previous Address

Yrs

Months

Married Single Divorced Common Law Widow

Marital Status*

Date of Birth*

DD/MM/YYYY

Home Tel. No.*

Mobile Tel. No.

Employment Details

Employed Self Employed Retired Unemployed Contract Worker

Employment Status*

Job Title*

Current Employer*

Employer's Address

Postcode

Time with Employer*

Telephone

Net Monthly Income*

Previous Employer

Address

Postcode

Time with Prev. Employer

Customer's Bank Details

Bank Name

Bank Address

Account Number

Sort Code

Data Protection Notice

In considering your application we and /or the credit provider ('We') will search your record at a credit reference agency /agencies. The records searched may be linked to your spouse or partner or any person with whom you are linked financially and other members of your household. They will add to your record details of your application. This will be seen by other organisations carrying out later searches. We may use a credit scoring or other automated decision making system when assessing your application. We will also add to your record with the credit reference agency/agencies details of information regarding  your payment record under your agreement with us. Information held about you by credit reference agencies may be linked to records relating to any person with whom you are linked financially and other members of  your household. We may give information about you and the conduct of your agreement to any proposed successor or assign and any proposed assignee, transferee or charge of your agreement or with us of our interest in such agreement, their insurers and advisers. It is important that you give us accurate information. We will check your details with fraud prevention agency/ 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 yourhousehold; to help make decisions on motor, household, credit, life and other insurance proposals and insurance claims, for you and members of your household; to trace debtors, prevent fraud, to manage your account or insurance policies; to check your identity to prevent money laundering, unless you furnish us with satisfactory proof of identity. Credit reference agency/agencies fraud prevention agency/agencies and we will also use the record for statistical analysis about credit, insurance and fraud. We may also use information about you to carry out market research. Please telephone us on 01352 718051 if you want to have details of those credit reference and fraud prevention agencies from whom we obtain and with whom we record information about you. You have a legal right to these details. You also have right, on payment for a fee, to receive a copy of the information we hold about you if you apply to us in writing. Please select the "I Accept" checkbox below, to give Dragon Auto Finance LTD permission to pass your details onto a third party for goods and services which we feel may be of interest to you .

I Accept