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Bank Account Introduction Form
PERSONAL DETAILS:
Compulsory Questions Marked With *
Status
Single
Living Together
Married
Seperated
Divorced
Widowed
*
Full Name
*
Data of Birth
*
Present Address
*
Post Code
*
How Long at Address
*
Years / Months
If under 3 years at present address, please give full details of previous address
Previous Address
Previous Post Code
How Long at Previous Address
Years / Months
Home Telephone
*
Mobile Telephone
Work Telephone
*
Your Email
*
default address
info@financetracker.net
Your Nationality
UK
EU
Commonwealth
Asylum Seeker
Other
*
Add to Mailing List
Yes
BANK ACCOUNT:
Account Type
Building Society Basic Cheque Account - £85
Building Society Cheque Account - £85
Offshore Cheque Account - Jersey/Isle of Man - £85
High Street Heavy Adverse Account - £85
Account for Undischarged Bankrupts, IVAs & Asylum Seekers - £85
Account for Undischarged Bankrupts & IVA - £85
High Street Basic Business Cheque Account - £85
High Street Basic Business Instant Access Cheque Account - £85
High Street Business Passbook Account - £85
*
BarclayCard Transaction ID:
If you paid by debit/credit card then enter the worldpay reference
EMPLOYMENT
DETAILS:
Are you Employed or Self Employed
Employed
Self Employed
*
How Long For
*
Years / Months
What is your Occupation
*
How Much do you Earn GROSS P/A
£
*
Can you Prove this Income
No
Yes
*
( pay-slips / P60 / Certified or Chartered Accounts )
Have you received Benefits in last 12 months
No
Yes
*
( Includes Housing Benefit or DSS Assistance )
ADVERSE CREDIT DETAILS:
Do you have any Current Arrears
Yes
No
*
If
Yes
Months For a Total of
£
If
YES
, Highest Arrears in Last 12 Months
Months For a Total of
£
Do you have any CCJ's
*
If
Yes
, For a Total of
£
PLEASE LIST ANY DEFAULTS / CCJ's / RENT~MORT. ARREARS / IVA's / BANKRUPTCY's BELOW
Type
Date Registered
Amount £
Paid Y / N
If Paid, Date Sat.
Explanation
.
CCJ
ARREAR
IVA
BKRCY
DEFAULT
.
DEFAULT
CCJ
ARREAR
IVA
BKRCY
.
DEFAULT
CCJ
ARREAR
IVA
BKRCY
PERSONAL DOCUMENTS:
PLEASE SELECT WHICH DOCUMENTS YOU HAVE OR CAN GET
Passport
EU ID Card
Benefits Book
Armed Forces ID Card
UK PhotoCard Driving Licence (full or prov.)
Police Warrant ID Card
Construction Industry Photo Registration Card
P60
P45
Residency Permit from Home Office to EU Nationals
NHS Card
Inland Revenue Tax Notification
Bank or Building Society Statement
Utility Bill
Council Tax Bill
Mortgage Statement
TV Licence Bill
Council or Housing Association Rent Bill
Council or Housing Association Tenancy Agreement
Private Sector Tenancy Agreement
Insurance Documentation
Letter from Solicitor
Letter from Doctor
Letter from Dentist
Letter from Ministry of Religion
Letter from Educational Institution
Letter from Employer or Job Agency
Letter from Social Worker or Hostel Manager
Application Registration Card (ARC) Issues by Home Office to Asylum Seekers
DECLARATION:
IS IT OK TO COMPLETE A CREDIT SEARCH
:-
Yes
( COMPULSORY )
To enable us to help find a suitable Bank for your financial enquiry, it is necessary to have your permission to forward your submitted details to a third party, eg. National Broker. Due to the Money Laundering Act, we cannot arrange the bank Account on your behalf. This service is an Introduction only.
DO YOU AGREE TO THESE TERMS (Y/N) :-
Yes
( COMPULSORY )
IF YOU DO NOT AGREE TO THE ABOVE THEN PLEASE DO NOT SUBMIT THIS FORM