Data Protection Act 1984: I consent to Active Vehicle Solutions using and disclosing the information contained in this form :-

1. To authorised agents and licensed credit reference agencies to make enquiries for credit assessment purposes. Such agencies will keep a record of the enquiry, and will share that information with other businesses.
2. To assist in fraud prevention and detection, and tracing debtors.
3. For registration with licensed credit reference agencies.

Under the Data Protection Act 1984 (The Act), information held by Active Vehicle Solutions will be used only for the purposes registered under The Act including general business purposes, making credit decisions and marketing.

I CONSENT TO THE ABOVE *

Applicant details -

Title
Surname *
First Name *
Initials
   Home Tel    Work Tel
Mobile Tel Date of Birth *
   Email Address
Male Female

Owner Tennant Living with parents
Single Married Other
Number of dependents
Address *
House Number Postcode *
Time at current address * Years Months

Driving Licence Number *
Number of Charge cards held
Number of Credit cards held
Number of Store cards held
Check/Credit card held Yes No

Bank Details -

Bank Name *
Sort Code *
Account Number *
Time With Bank * Years Months

Contract Details -

Payment Profile *
Annual Milage *
Full Make / Model *
Monthly Rental *
Body Type *
Maintanance Yes No
Replacement of existing vehicle Yes No

New Used