YES Finance Retail Facility Application Form

This section allows you to apply for your Retail Facility over the Internet.

Once we have received the information we need to process your application we will inform you whether your application has been successful (subject to terms and conditions).

Alternatively you can download our application form and post or fax it to us.

Remember if you have any queries first check out the frequently answered questions, if you can't find the answer there please contact us.

Please fill in the following details:

Fields marked with a * are required to be filled out.

1)	Company details:
	*Registered name		Trading name
	Company number
	*Address of registered office
	P.O. Box number
	Phone number		Fax number
	*Authorised person email address

	Shop Manager		Branch
	Address of Shop
	Phone number		Fax number
	E-mail address

2)	Partnership/Shareholders details:			*
a)	First name		Family name
	Current address

	Shareholding
b)	First name		Family name
	Current address

	Shareholding
c)	First name		Family name
	Current address

	Shareholding

3)	Trade References:
a)	Name		Phone
	Current address

b)	Name		Phone
	Current address

c)	Name		Phone
	Current address


	Comments/relevant additional information

	Privacy Act 1993
	I/We: (a) warrant that the information provided in this application is true and correct; (b) authorise Yes Finance Loans to contact my/our employer, any credit agency and any other source (each a "source") to obtain, check and exchange (both now and in the future) information in connection with this application and any agreement that I/we may hereafter enter into with Yes Finance Loans. (c) Acknowledge that by ticking the below box on this application shall operate as an authority to each Source to provide Yes Finance Loans with any information about me/us which Yes Finance Loans may require in connection with this application or any such agreement; (d) acknowledge that this application will form part of any agreement I/we may hereafter enter into withYes Finance Loans and that the authorisation set out above will be deemed to be incorporated into that agreement. You are entitled, under the provisions of the Privacy Act 1993, to (a) have access to personal information held by Yes Finance Loans about you; and (b) request correction of any personal information held by Yes Finance Loans about you;
		I/We agree that the information in connection with this finance application may be transmitted via facsimile and/or electronic mail, and I/we acknowledge that there may be some security risks associated with the transmission.

a)	Name of applicant
	Email address
b)	Name of applicant
	Email address

		I/we have read and accept the terms and conditions within this application/authorisation		Tick here