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MIDWEST RACING CAN HELP YOU WITH FINANCE

Midwest Racing can help you with your new Husqvarna bike.

Finance Your Husqvarna Bike with Midwest Racing

Finance Your New Bike

Fill in the form details to the right, make sure all your details are correct before submitting the form.

We look forward to hearing from you and will get back to your request as soon as possible. If you have any questions please feel free to contact us.

Thank you for your interest with Midwest Racing.

MOTORCYCLE DETAILS

Bike Model
Bike Price
New or Used

PERSONAL DETAILS

Full Name (as it appears on drivers licence)
Marital Status
Date of Birth (dd-mm-yyyy)
Home Phone Number
Accommodation Details
Dependents (ie. Children under 18)
Mobile Number
Email Address
Daytime Phone Number

ADDRESS INFORMATION

Current Address

House Number / Name
Road
Town
Postal Code
Time at Address (years)
Time at Address (Months)
Does your driving license show this address?

If you have lived at your current address for less than 3 years, please fill in further addresses:

Previous Address

House Number / Name
Road
Town
Postal Code
Time at Address (years)
Time at Month (years)

EMPLOYMENT AND OCCUPATION INFORMATION

Employment Status:
Occupation:
Employers Name
Work Address Property No
Work Address Road
Work Address Town
Work Address Post Code
Time in Current Employment (years / months)

Previous employer if at current employer less than 3 years.

Employers Name
Work Address Property No
Work Address Road
Work Address Town
Work Address Post Code
Time in Employment (years / months)

BANKING AND DEPOSIT INFORMATION

Bank Sort Code
Account Number
Bank Name
Bank Address
Time with Bank (years)
Amount of Deposit (£)
Loan Required (£)
Loan Term
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