Motorway Referral Enquiry Form

Main Details

Legal Trading Name *0 / 50

Key Contact Full Name *This individual should have authority to sign documents on behalf of the business.

Email Address *

Mobile Telephone Phone *

Your Dealership Details

Business Type *

Street Address *Trading Address

City

Postal Code

Is Your Trading Address Different to Your Registered Address? *

Street Address *Registered Address

City

Postal Code

Autotrader Link

Website URL

Company Number *

Length of Time Trading *0 / 50

VAT Registration Number

FCA Permissions Held0 / 50

Are Your Premises Owned or Leased? *

Lease Terms *0 / 50

Requested Stocking Facility Size *

Your Stocking Details

Main Type of Vehicles Sold *0 / 50

Approximate Total Value of Stock *

GBP

Is Your Stock Stored at Any Other Address? *

Street Address *

City

Postal Code

Do You Have Existing Stock Funding in Place? *

Name of Existing Stock Funder *0 / 50

Facility Amount *

GBP

Amount Currently Utilised *

GBP

Director Details

First Name *

Middle Name

Surname *

Date of Birth *

Private Address *0 / 180

Time at Private Address *0 / 50

Previous Address (1)0 / 180

Time at Previous Address (1)0 / 50

Previous Address (2)0 / 180

Time at Previous Address (2)0 / 50

Are You a Homeowner? *

Home Residence Value *

GBP

Remaining Mortgage Amount *

GBP

Shareholder Details

First Name *

Middle Name

Surname *

Date of Birth *

Private Address *0 / 180

Time at Private Address *0 / 50

Previous Address (1)0 / 180

Time at Previous Address (1)0 / 50

Previous Address (2)0 / 180

Time at Previous Address (2)0 / 50

Are You a Homeowner? *

Home Residence Value *

GBP

Remaining Mortgage Amount *

GBP

Privacy

For information about how we use your personal information as part of this application, please see our privacy policy which can be found on our website here.

Please select your preferences below:

Please sign below to confirm that the answers to the questions set out above are true and accurate to the best of your knowledge and that you understand that LE Capital will be relying on this information when making our decision to provide a stock funding facility for your business.

Signature *

Print Name *

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