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Fill in your details in the secure form below and click on submit to send your details or simply email info@afm.ie. A member of the AFM team will contact you promptly.

 

Company / Sole Trader Details

 
Customer:

Trading as :
Email : ( compulsory )
Previous Address ( if less than 3 years)
Address:
Contact Name : Telephone:
Fax: Nature of Business: Years in Business :
Main Customers: No. of Employees : Turnover : €
Auditors : Auditors Telephone : Company Reg. No :
Client Bankers : Existing Client :    
   
Business Summary :        
   

Directors / Sole Trader / Indemnifier  Details

Director 1
Name:
Home Address:
  

Time at Address:

 Marital Status:
Are you :
Home Tel : Mobile No : D.O.B.
Personal Guarantees Available :
Director 2
Name:
Home Address:
  

Time at Address:

 Marital Status:
Are you :
Home Tel : Mobile No : D.O.B.
Personal Guarantees Available :

Current Bank Details
Name/Address of Bank:
Account Name:

Account Number:

 Sort Code :    
     

Asset Details

Make / Model / Type:
Asset Details :

Net Price : €

Payment Method :
Net advance : Term / Upfront : € Buyback :

Supplier Details

Supplier:
 Supplier Address :  
 
Supplier Tel. No :

Supplier Contact Name :

  

Other Information i.e personal knowledge

Any other information :
   
Date : Introducer : Tel :