VW Website Finance Application Form

Select Your Preferred Location

Which vehicle are you interested in?*

Trade-in or Deposit Amount*

Term you would like to finance*

Outstanding loan on your trade-in*

Title*

First Name*

Surname*

Maiden Name

Phone Number*

Email Address*

Date of Birth*

Gender*

Marital Status*

Address name or number*

Street*

Town*

County*

Post Code

Time at this address (in years)*

Previous address name or number (if less than 3 years at current address)

Previous Street

Previous address Town

Previous address County

Residential Status*

Who do you normally bank with?*

If other bank, please specify

Occupation*

Identification Type*

Identification Number (e.g. PPS Number)*

Employment Status*

Employer Name*

Address name or number (Work)*

Street (Work)*

Town (Work)*

County (Work)*

Years with Employer*

Previous Employer name (if less than three years with current employer)

Years with previous employer (if less than three years with current employer)

Telephone (Work)*

Monthly Income after Tax*

Warning: If you do not meet the repayments on your credit agreement, your account will go into arrears. This may affect your credit rating, (which may limit your ability to access credit in the future). The information that you provide on this proposal form will be forwarded to one or more financial institutions, being members of the Irish Finance Houses Association, and will be used by them for the purposes of assessing the suitability for you of their finance products, potentially offering you a product or a quote. As part of this process, credit searches will be made with one or more credit reference agencies, including the Irish Credit Bureau (ICB), which will make a record of the search. Details of any agreement you enter into, and your conduct of that agreement, may be shared with the credit reference agencies, ICB and their members. Searches may also be carried out to verify your identity, and you may be contacted directly (including by telephone) for the purposes of verifying the information on this form. Credit scoring and other automated decision-making process may be used. By ticking the consent box below, I certify that I consent to the use and disclosure of this information for the purposes set out above. I acknowledge that the recipients of this information are authorised to contact me and to disclose any material misstatements of fact on this proposal to their members and other relevant bodies.

As a credit intermediary we are required under section 148 (e) of the Consumer Credit Act 1995, to disclose to you that we can receive a commission from the Bank or financial institution for arranging this finance agreement.

Tick here to confirm consent by application*

Yes

Tick here to confirm you are over 18 years of age*

Yes

Loan Details

Personal Details

Employment Details

Data Protection and Consents