A1 Capital - a fresh approach to business finance - 01937 588 084 - Proposal Form

Business Name*

Trading Address*

Postcode*

Tel No*

VAT No

Co Reg No

Established

Type of Business

E- Mail*

Director/Partner 1

Name*

D.O.B* (format YYYY-MM-DD)

Address*

Tel No*

Owner or Rented*

For how long?*

If less than 3 years complete the previous address below

Address

For how long?

Director/Partner 2

Name

D.O.B (format YYYY-MM-DD)

Address

Tel No:

Owner or Rented

For how long?

If less than 3 years complete the previous address below

Address

For how long?

Bank

Sort Code

Account Name

Account No

Asset Description

Date of Manufacture (format YYYY-MM-DD)

Serial/Reg No

Supplier

Cost Price

VAT

Tel No

Total Cost

Product

Profile

Data Protection Notice – How we use your information

This notice applies to all applicants and (if the application is made by a limited company or partnership/unincorporated association) directors and partners.

We will check your details with credit reference and fraud prevention agencies (“the agencies”)and they will record our check and provide us with information about you. We will tell the agencies if we thinks you’ve given false information or suspect fraud. We also give credit reference agencies information how you manage your account. We and other companies will use this information to assess you and your household for credit and credit related services, motor household credit, life and other insurance proposals and claims, debt tracing and recovery, prevention of fraud and money laundering, statistical analysis about credit, insurance and fraud, market research. We may use credit scoring techniques to help us assess your proposal.

Please write to us at 5 Shaw Barn Croft, Wetherby, LS22 6GN if you want a copy of the information we hold on file about you

Use of Personal Information

1. to allow administration and the operation of your Account.
2. to assisti credit assessment. Enquiries may be made with licensed credit reference agencies who will keep a record of the Bank’s enquiry. However,we will only disclose

Information about a customer’s account to agencies in the event of default on a debt.

1. to assist in detecting and preventing possible fraudulent transactions.
2. to allow us to offer services, including those of Group and other companies, which may be appropriate to your needs.

If you prefer not to receive information about such services please tick this box.

The Bank has registered its usage of data under the Data Protection Act 1984 and you are entitled to obtain a copy of information held about you, upon payment of the appropriate fee

Sign on behalf of Business Name* (Applicant 1) print Name

Sign on behalf of Business Name (Applicant 2) print Name if partnership

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