Car Finance enquiry
Mertrux, The area's leading independent used Mercedes specialist

*First name

*Surname

*Contact phone number

*Email address

*Address

Date of birth

Time at current address
Years

Months

Home status
Owner
Tenant
With parents
Marital status
Married
Single

If less than 3 years at current address please complete the following section
Previous address (if less than 3 years at current address)

Previous postcode (if less than 3 years at current address)

Time at previous address (if less than 3 years at current address)
Years

Months

Occupation

Employed
Self employed
Time with employer (if applicable)
Years

Months

Employers name and address

Employer postcode

Employer telephone number

Paid
monthly weekly fortnightly
Net income per Month/Fortnight/Week*
Period depending on previous question
£
Which bank do you use

How long have you been with them
Years

Months

What credit cards do you currently hold (EG. Visa & MasterCard)

If less than 3 years with your current employer please complete the following section
Previous occupation

Previous employer name and address

Time with previous employer
Years

Months

Make

Model

Petrol
Diesel
LPG
Transmission
Manual
Automatic
Type (EG 4x4, Convertible, Estate)

Maximum mileage considered

Colour likes

Colour dislikes

What is your estimated monthly budget

How would you like to be contacted
Email
Phone
Post
When would you like to be contacted
Time

Date

Please note:
Whenever possible we will endeavour
to contact you at this time and date.

*Denotes mandatory fields