R&M Rentals :: Digital LCD, Plasma, Washing Machine, Tumble Dryer, Dishwasher & Fridge Rental Hire

Application Form

By completing and sending the form below, you are granting R&M Rentals Ltd permission to perform a credit check under the terms of the data protection act. We hereby notify you that using the information you provide, we will make a search with a credit reference agency. This search will be held on file, we will monitor and record information relating to your payment history and such records will be made available to credit reference agencies who will share that information with other businesses in accessing applications for credit and fraud prevention.

Personal Details Title: Mr Mrs Miss Ms
Forename & Initials:
Surname:
Date Of Birth: / / (dd/mm/yy)
Home Phone:
Mobile:
Email:
Marital Status:
Maiden Name:
Partner/Spouse's Name:

Your Home Is Your Home: Owned Rented Parents
Contents Insurance?: Yes No

Address Line 1:
Address Line 2:
County:
Postcode:

Are You On Voters Roll?: Yes No

If you have not been at your address for more then 3 years, please provide your previous address below:

Previous Address Line 1:
Previous Address Line 2:
Previous County:
Previous Postcode:

If you rent your home, please provide us with landlords / mortgage holders details below:

Landlord's Name:
Landlord Address Line 1:
Landlord Address Line 2:
Landlord County:
Landlord Postcode:

Employment Employment Status: Employed Self Employed
Present Occupation:
Address Line 1:
Address Line 2:
County:
Postcode:

Work Phone (inc ext):

If you are employed:

Employer:
How Long Here?: Year(s)

If you are self employed please supply your accountants details:

Accountant's Name:
Address Line 1:
Address Line 2:
County:
Postcode:

Other Information How Did You Hear Of Us?:

If you are outside of our catchment area, would you like us to forward on your details to your local rental specialist?:

Forward Details?: Yes No

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