Hire Purchase Application | Kane Financial Services

"*" indicates required fields

Main Customer

Title*

Full name*

Address*

Street Address Address Line 2 City Postcode

Years at Address*

Months at Address*

Previous address*

Street Address Address Line 2 City Postcode

Date of birth*

Telephone number*

Contact email address*

Gender*

Maritial Status*

Residential Status*

Dependants*

Country of Nationality*

Country of birth*

Driver's License No.*

Mother's maiden name*

Occupation*

Employer*

Employer address*

Street Address Address Line 2 City Postcode

Employer telephone number*

Years with employer*

Months with employer*

Employment status*

Bank name*

Bank address*

Street Address Address Line 2 City Postcode

Years with bank*

Months with bank*

Name on account*

Sort code*

Account no.*

Joint Customer*

Yes

Joint customer details

Title*

Full name*

Address*

Street Address Address Line 2 City Postcode

Years at address*

Months at address*

Previous address*

Street Address Address Line 2 City Postcode

Date of birth*

Telephone number*

Contact email address*

Gender*

Maritial Status*

Residential Status*

Dependants*

Country of birth*

Country of nationality*

Driver's License No.*

Mother's maiden name*

Occupation*

Employer*

Employer address*

Street Address Address Line 2 City Postcode

Employer telephone number*

Years with employer*

Months with employer*

Employment status*

Main Customer Income

Gross annual salary*

Net annual salary*

Other*

Salary mandated

Salary date*

Main Customer Outgoings

Mortgage*

Rent*

Loans / Hire purchase*

Credit Cards

Overdraft*

Other**

Total outgoings*

Additional Information

Joint Customer Income

Gross annual salary*

Net annual salary*

Other*

Salary mandated

Salary date*

Joint Customer Outgoings

Mortgage*

Rent*

Loans / Hire purchase*

Credit Cards*

Overdraft*

Other*

Total outgoings*

Additional Information

Goods (Vehicle)

Vehicle type

Reg No.

Reg date [mm/yy]

Chassis No.

Make

Model

Trim

Engine size (cc)

Mileage

Doors

Body style

Transmission

Fuel Type

Cap Code

Est Annual Mileage

Goods (non-Vehicle)

Description

Finance Details

Finance type*

Invoice price*

Cash deposit*

Part Exchange*

Direct Deposit*

Advance payments*

Read fund licence*

Settlement of existing finance*

Previous finance company*

Previous finance agreement No.*

Amount of credit*

Monthly instalments / Rental*

Balloon / GFV*

Total advance payments (lease only)

Number of advanced payments (lease only)

Followed by (lease only)

Rate*

Term years*

Term Months*

Subsidy*

Acceptance fee*

First payment

Spread

Is cash deposit greater than 10K and in hard cash?*

Yes

Please detail source of deposit*