C I LEASING PLC CONSUMER LEASE APPLICATION FORM by laa10797

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									C & I LEASING PLC
CONSUMER LEASE APPLICATION FORM
APPLICATION FORM FOR CONSUMER LEASE
PERSONAL DATA
NAME (surname first)                       -------------------------------------------------------------------------------------------------------
RESIDENCE (not P O Box)                    -------------------------------------------------------------------------------------------------------
                                           -------------------------------------------------------------------------------------------------------
PERMANENT HOME ADDRESS -------------------------------------------------------------------------------------------------------
(Village/Home town)                        -------------------------------------------------------------------------------------------------------
DATE OF BIRTH ----------------------------- SEX ------------------------------               NO. OF DEPENDANTS ---------------------


EMPLOYMENT DATA
EMPLOYER                  ------------------------------------------------------------------------------------------------------------------------
OFFICE ADDRESS ------------------------------------------------------------------------------------------------------------------------
                          ------------------------------------------------------------------------------------------------------------------------
POSITION HELD             ------------------------------------------------------------------------------------------------------------------------
ANNUAL SALARY --------------------------------------- MONTHLY TAKE HOME PAY ---------------------------------------




EQUIPMENT DATA
S/NO.                     NAME OF EQUIP                           MODEL/DESCRIPTION                                     EXPECTED COSTS




HOW MUCH ARE YOU WILLING AND ABLE TO CONTRIBUTE N ----------------------------------------------------------
FOR HOW LONG DO YOU WANT THIS FACILTY --------------------------------------------------------------------------------


DECLEARATION
I DECLARE THAT THE ABOVE INFORMATION I HAVE GIVEN IS TRUE AND CORRECT


SIGNED ----------------------------------------------------------------------------------------------------------------------------------------
NAME       ----------------------------------------------------------------------------------------------------------------------------------------
DATE       ----------------------------------------------------------------------------------------------------------------------------------------


TO THE EMPLOYER
THE ABOVE NAMED PERSON WHO WORKS FOR YOU HAS REQUESTED US TO GRANT HIM A PERSONAL LEASE
FACILITY. PLEASE CONFIRM BY SIGNING BELOW THAT:
    1.     HE IS A BONA FIDE STAFF OF YOUR ORGANISATION
    2.     HE IS A SUITABLE PERSON TO WHOM A LEASE FACILITY AS REQUESTED ABOVE CAN BE EXTENDED
    3.     AT THE INSTANCE OF THE APPLICANT THE RENTALS PAYMENTS WILL BE DEDUCTED AT SOURCE FROM
           HIS MONTHLY PAY AND THE PROCEEDS OF THE DEDUCTION REMMITTED TO US
    Note: It is not intended that this confirmation shall carry with it any contingent liability whatsoever on the part of the
    employer.


SIGNED ---------------------------------------------------------------------------------------------------------------------------------------
NAME ------------------------------------------------------- POSITION HELD ----------------------------------------------------------
DATE -------------------------------------------------------------------------------------------------------------------------------------------
                                                      CALL MEMO
                                                                       DATE OF VISIT --------------------------
NAME OF ORGANISATION / CUSTOMER VISITED -------------------------------------------------
                                                  ---------------------------------------------------------------------
ADDRESS OF ORGANISATION / CUSTOMER --------------------------------------------------------
                                                  ---------------------------------------------------------------------
NAME(S) OF PERSON(S) PRESENT ---------------------------------------------------------------------
                                                  ---------------------------------------------------------------------
DISCUSSION HELD:
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SIGNED --------------------------------------------         DATE -------------------------------------------------
NAME        -----------------------------------------------------------------------------------------------------------


SUPERVISOR’S COMMENT: -------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------
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SIGNED ---------------------------------------------        DATE --------------------------------------------------
NAME        -----------------------------------------------------------------------------------------------------------

								
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