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Business Name:*
Telephone Number:*
Fax Number:
Website:
Main Contact Name:*
Position:
Direct Telephone:
Mobile Number:
Email Address:*

Business Address:

Postcode:*
Building Name/No:*
Line 1:*
Line 2:
Line 3:
Town:*
County:*

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Business Structure

Sole Trader:
Partnership:
Limited Company:
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Nature of Business:*
Date Established:* / /
VAT Number:
Bankers Name:
Bank Sort Code: - -
Bank Account Name:
Account Number:

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Number of Partners/Directors

One:
Two:
Three:

Four:
Five:
Six:

Equipment Description:*
Equipment Cost:*

£
exclusive of VAT
Finance Period:* years

Partner/Director 1

Name:*
Date of Birth:* / /
Home Address:Home Address
Postcode:*
House Name/No:*
Line 1:*
Line 2:
Line 3:
Town:*
County:*
Period at Address:

Freehold:
Rented:
Leasehold:
Parents:

Approximate Value: £
Approximate Mortgage: £
Previous Address (if less than 3 years above):
Postcode:
House Name/No:
Line 1:
Line 2:
Line 3:
Town:
County:

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Partner/Director 2

Name:*
Date of Birth:* / /
Home Address:Home Address
Postcode:*
House Name/No:*
Line 1:*
Line 2:
Line 3:
Town:*
County:*
Period at Address:

Freehold:
Rented:
Leasehold:
Parents:

Approximate Value: £
Approximate Mortgage: £
Previous Address (if less than 3 years above):
Postcode:
House Name/No:
Line 1:
Line 2:
Line 3:
Town:
County:

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Partner/Director 2:
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Partner/Director 3

Name:*
Date of Birth:* / /
Home Address:Home Address
Postcode:*
House Name/No:*
Line 1:*
Line 2:
Line 3:
Town:*
County:*
Period at Address:

Freehold:
Rented:
Leasehold:
Parents:

Approximate Value: £
Approximate Mortgage: £
Previous Address (if less than 3 years above):
Postcode:
House Name/No:
Line 1:
Line 2:
Line 3:
Town:
County:

Please read the terms and conditions and tick below to accept.

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Partner/Director 3:
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Partner/Director 4

Name:*
Date of Birth:* / /
Home Address:Home Address
Postcode:*
House Name/No:*
Line 1:*
Line 2:
Line 3:
Town:*
County:*
Period at Address:

Freehold:
Rented:
Leasehold:
Parents:

Approximate Value: £
Approximate Mortgage: £
Previous Address (if less than 3 years above):
Postcode:
House Name/No:
Line 1:
Line 2:
Line 3:
Town:
County:

Please read the terms and conditions and tick below to accept.

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Partner/Director 4:
I consent to my data being processed:

Partner/Director 5

Name:*
Date of Birth:* / /
Home Address:Home Address
Postcode:*
House Name/No:*
Line 1:*
Line 2:
Line 3:
Town:*
County:*
Period at Address:

Freehold:
Rented:
Leasehold:
Parents:

Approximate Value: £
Approximate Mortgage: £
Previous Address (if less than 3 years above):
Postcode:
House Name/No:
Line 1:
Line 2:
Line 3:
Town:
County:

Please read the terms and conditions and tick below to accept.

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Partner/Director 5:
I consent to my data being processed:

Partner/Director 6

Name:*
Date of Birth:* / /
Home Address:Home Address
Postcode:*
House Name/No:*
Line 1:*
Line 2:
Line 3:
Town:*
County:*
Period at Address:

Freehold:
Rented:
Leasehold:
Parents:

Approximate Value: £
Approximate Mortgage: £
Previous Address (if less than 3 years above):
Postcode:
House Name/No:
Line 1:
Line 2:
Line 3:
Town:
County:

Please read the terms and conditions and tick below to accept.

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Partner/Director 6:
I consent to my data being processed:

Thank you for your message. You were very professional and helpful during the whole process and after as well. Thank you again.

Alex Galindo - HARTZAK LImited

Focus Leasing, 1 London Road Office Park, London Road, Salisbury. SP1 3HP

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