LoanClaimerQuestionnaire

Issue 6.1 LoanClaimer 2008

CAR LOANS Account Holder’s Name(s) Address Telephone number E-Mail address 1) Name of original lender 2) Address the account relates to: (If different from above) 3) Did you sign a Loan agreement or HP Agreement? 4) Was a broker involved or arranged by Forecourt? If Yes, name of Broker Firm 5) Has this account been assigned to another Lender, if so who? 6) Original Loan amount (approx if not known) 7) Enter the amount of any further advances? 8) In what year did you take out the loan? 9) If the loan has been paid off, in what year was it?

Loan / HP Agreement

Yes / No

LoanClaimerQuestionnaire

Issue 6.1 LoanClaimer 2008

CAR LOANS 10) Did you have to pay a guarantee premium because you were borrowing an amount close to the value of the property? 11) Has the loan ever been in arrears?

(Delete as appropriate) 16) Has the Vehicle been repossessed?

17) If so, Is there still a balance outstanding? If you have any other information relevant to your Loan, please enter the details below

Yes / No

No / Once / Occasionally / Frequently / Threatened Repossession

Yes / No

Yes / No