Alan Duffus Motorcycles Alan Duffus Motorcycles  

Alan Duffus Finance Application

Please complete the following form. Upon receipt we will process your application and contact you.
Please note: This application is not a guarantee of finance, nor is it a binding contract.
The information you provide on this form will be used solely to give you a preliminary idea of the finance options available to you. It will not be passed on to any third parties.
Black Horse Finance Black Horse Approved Dealer
Personal Details
Title (Mr, Dr etc)ForenameSurname
Date of BirthMarital StatusPrevious Surnames
Married Single Widowed Divorced/Separated
Number of Dependent Children
Home TelephoneMobile TelephoneWork Telephone
Address Details - We require 3 years of address history
Residential Status Home Owner Tenant Living With Parents
Current AddressTime at Address
Years: Months:
Previous Address 1Time at Address
Years: Months:
Previous Address 2Time at Address
Years: Months:
Employment Details
Employment StatusEmployment TypeOccupation
Full Time
Part Time
Time with EmployerYears: Months:
Employer Name
Post Code
Phone Number
Financial Details
Bank/Bldg.Soc. Sort Code
Time with BankYears: Months:
Cards HeldCheque Guarantee Visa Access Other
Payment Protection PlanIf you would like your payments protected for life/accident/sickness and redundancy please indicate here. You should be aware that payment protection will incur a slightly higher monthly payment that taking a loan without this plan.
Yes No
If you indicate approximately how much you would like to put down as deposit and roughly how much a month you would like your payments to be then we will propose the application that is closest to your indicated monthly figure.
My preferred deposit would be
My preferred monthly payment would be
Motorcycle Details
Registration No.Please enter the registration number of the motorcycle you are interested in - we will fill in the rest.
Part Exchange Details
MileageRegistration NumberYear of Manufacture
Other Information
Please enter any other information, e.g. after market mods. etc.
Other Information
Please enter any other information you feel we should know regarding this proposal.
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