PROPOSAL FORM

Consolidated Asset Finance Contact Name: Tom Date

We wish to apply for finance facilities for our customer as stated below. We understand that this application is subject to contract and that the transaction can only be completed after the lessor has accepted the proposal and executed the finance contract.

CUSTOMER DETAILS
Name:
Address:
Tel:			Fax:			Web site:
Contact: Tom			Position:			E-mail:
Date Established:			Co. Reg. No:			Vat Reg. No:
Nature of Business:
EQUIPMENT DETAILS
							Cost
SUPPLIER DETAILS
Name:
Address:
Contact:					Tel:
Fax:			Web site:			E-mail:
DEAL PARTICULARS
Facility Lease Required: (Lease/HP/Loan/Other)							Period months (years)
Repayment Profile: Followed By:
DIRECTORS/PARTNERS DETAILS (if sole trader/partnership or ltd co, established less than 3 years)
Full Name:					Full Name:
Address:					Address:
Date of Birth					Date of Birth
House Value:	Mortgage:				House Value:			Mortgage:
If at above address for less than 2 years please provide previous address.					If at above address for less than 2 years please provide previous address.
If there are more than 2 partners, please provide their details on a separate sheet.
BANK DETAILS					CONSENT FORM
Bank Name:
Address:
Sort Code		_		_	Signed
Account Number					Dated

Tel: +353 1 4062290 Fax: +353 1 4911594 E-mail Tom@cafl.ie