Pace Packaging Ltd - Credit Search Descision Request Form

Credit Search Descision Request Form

Introducer		Company Name
Introducer's Name		Telephone
FSA Number		Fax

Customer Name(s)

Title		Title
Forename		Forename
Initials		Initials
Surname		Surname
D.O.B.		D.O.B.

Has either applicant changed their name?		Yes		No
If yes please provide details

Current Address

First Applicant

Second Applicant

If same as applicant 1 please tick

Address

Town

County

Country

Postcode

Date moved into current address

Previous Address - If less than 3 years at current address:

Address		Address
Town		Town
County		County
Postcode		Postcode

If time at both previous addresses is less than three years, please provide details of previous addresses covering the last three years on a separate sheet.

Does the applicant currently have a mortgage?

Yes

If yes: Amount of current balance £

Monthly repayments £

IMPORTANT - Use of your information:

In considering your application we will search your record at a Credit Reference Agency. They will add to your record details of our search and your application and this will be seen by other organisations that make searches.

Your record will be shared with other organisations and used by them to help make decisions about credit for you and memmers of your household, and to trace debtors, recover debt, prevent money laundering and fraud.

Birmingham Midshires and the Credit Reference Agency may also use your information for statistical analysis about credit.

Declaration

I have confirmed the information given above with my client and have authority to agree as above on behalft of him/her/them.