Car loan application form (Available to French residents only) Applicant Details Applicant 1 Applicant 2
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1 Applicant Details Applicant 1 Applicant 2 Title Full Name Maiden Name (if applicable) Mr Mrs Miss Mr Mrs Miss Date of Birth Address Post code Current residential status How long have you resided at this address? address Owner Tenant _ Owner Tenant _ Telephone Number(s) (landline and mobile) Place & Date of Birth (town & country) Nationality Marital status Number of dependents Britline Account Number Keep up to date with CA Britline products and services I/we accept to receive commercial messages and offers by: Text Telephone I/we do not accept to receive commercial messages and offers: Signature(s): 1/6
2 Employment & Financial Details Applicant 1 Applicant 2 Occupation Status Type of Contract Employed Self-employed Retired Full time Part time Temporary Permanent Employed Self-employed Retired Full time Part time Temporary Permanent Start Date Monthly Net Salary Other Monthly Income Monthly Family Allowance Outgoing Rent/Mortage Payments Other Charges (i.e. maintenance, credit card balances etc) Other Loan Repayments 2/6
3 Loan details Funding Personal Contribution (if applicable) Loan Amount Required TOTAL Purpose of the Loan Term required in months: Loans can range from 12 to 72 months Please use this space for any further comments regarding the loan requested: List of documents to be provided to complete an application - Last three months pay slips, Avis d imposition, annual pension statement and/or latest P60. - Last 3 months bank statements for all accounts held. - Bon de commande (order form), or signed letter from seller confirming their name, your name, the make, model, registration n and sale price of the car. - Proof of personal contribution to the project (if applicable). - Copy of passport if you have held your bank account with CA Britline for more than 3 years. 3/6
4 Car Insurance If you would like to have an Insurance quote for vehicle, please complete the details below: Do you or will you drive less than 5,000 km a year with this vehicle? Yes No What date would you like the contract to start? What is the date d etablissement of the carte grise (purchase date)? If you are not in possession of this yet, please insert todays date. What is the age of the car (month and year)? If you are not in possession of this yet, please insert todays date. / What is the postal code of where the vehicle is usually kept? Example: Which commune corresponds to the postal code? If known provide the registration no. of the vehicle you wish to insure Make of vehicle Model Engine size Power (Puissance Fiscale) Body type Fuel (example: diesel/petrol) Who is the main driver? Title & full name Date of birth of main driver? If other than applicant 1 or 2 What date did you pass your driving test? Occupation of main driver? If other than applicant 1 or 2 4/6
5 Car Insurance/continued Will the vehicle used for private & pleasure or business use? How many months within the last 18 months have you been Insured? How many claims have you made in the last 3 years? (including no blame) What is the renewal date of your current insurance contract? What was your no claims bonus or CRM at your last renewal date? How long have you owned your previous vehicle? Why type of cover would you like? Third party Fully Comprehensive Who was your previous car insurance provider? How would you like to pay for your car insurance? Monthly Annually 5/6
6 Terms and conditions/ Declaration I / We declare that: - The information given above and in any attachment, in particular the description of other loan commitments, level of income and property, is true and accurate and is to be regarded as forming part of any subsequent contract with the lender (and the insurers) and acknowledge that I / we will be liable for any loss suffered by them as a result of reliance upon my / our statements. - I / We certify that the loan requested will not lead to a debt which is out of proportion with my / our income. - I / We authorise any enquiries considered necessary for the confirmation of the above particulars and for credit assessment. - I / We authorise the lender to disclose to Crédit Agricole, their representatives, or their Solicitor, such information as they may request concerning any existing or previous accounts, including redemption details. - I / We authorise the disclosure of any information relating to this application to the other applicant(s), credit reference agencies and to any other person acting on behalf of the lender. - I / We appreciate that this application may be declined without a reason being stated SIGNATURE OF APPLICANT(S): 1- Date.. 2- Date... Please return this application form to: CA BRITLINE 15, Esplanade Brillaud-de-Laujardière, CS 25014, CAEN Cedex 4 France Tel: (0) (1) Fax: (0) (1) britline.mortgage@ca-normandie.fr web site : (1) (1) Local costs apply when phoning within France from a fixed line. Check with your service provider when calling from abroad. Free access by internet (excluding fees charged by your service provider) Thank you for the time taken to complete this application. 6/6
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