Application Form Limited Company

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Company Name

Company Trading Name

Company Number

Business Address

Yard Address / Address where machinery kept (If Different)

Date Established

VAT Registered?(Required)

Yes

VAT Number

Total number of employees

Do you operate in the Agricultural Sector?

Main Business Activity

Farm Size

Acres

Tenancy

Crops

Quantity (acres)

Yield/Price

Crop Type

Livestock

Quantity

Yield/Price

Livestock Type

Overdraft Limit (if applicable)

Any future plans for the business (expansion etc)

Has the business ever:

Made arrangements with creditors including CVAs(Required)

Yes

Had a property reposessed?(Required)

Yes

Had a court order for debt registered against it?(Required)

Yes

Failed to keep up repayments on any financial arrangement the business has entered into?(Required)

Yes

Broken any credit agreements?(Required)

Yes

Is there any information that you are aware of that may affect the success of the application that you feel you can provide to best assist us

Have any of the directors been disqualified from running a business or been subject to sanctions(Required)

Yes

Directors

Title

Full name including any middle names

Date of birth

DD slash MM slash YYYY

Full address

Date of entry to address

Previous Address if less than 3 years

Director Telephone Number

Director Email

Ownership Status

I consent to verify my identity and address electronically(Required)

Yes

I confirm I have seen and agree with the disclosures provided in step one.(Required)

Yes

I understand that any personal data that I provide during the completion of this application form will be processed on the basis of Bithell Davies Funding Solutions Limited's legitimate interest, which is to consider my request for arranging finance for my business or personal needs. I acknowledge that, in doing this on my behalf, Bithell Davies Funding Solutions Limited may use my personal data to enable a lender to make credit decisions and may share it with lenders, credit reference, and fraud prevention agencies. My personal data will be processed in accordance with Davies Funding Solutions Limited’s privacy policy. This policy can be viewed here: https://bithelldavies.com/app/uploads/2025/12/Privacy-Policy-V2.112025.pdf

I understand that if my application for finance is unsuccessful, Bithell Davies Funding Solutions Limited will only keep my personal data until it can be securely deleted from their systems, which will happen within a maximum of 12 months. I, the customer/applicant, confirm that I have read this statement and have been given the opportunity to read and accept Bithell Davies Funding Solutions Limited’s privacy policy.

Please confirm your acceptance of the above(Required)

Yes

Please Add Details For Individual

Details for Machinery / Finance

Make

Model

Year Of Manufacture / New

Price

Is VAT Applicable?

Yes

Type of transaction(Required)

Facility Type

Supplier Name

Supplier Contact Name

Supplier Phone Number

Do you wish to defer the VAT?

Up Front Deposit Amount Separate To Any VAT

Term (Months)

Payment Frequency

Would you like information on seasonal payment options?(Required)

Yes

Would you like ito schedule lump sum payments?(Required)

Yes

Do you have budget in mind?

Have you considered affordability of any repayments?(Required)

Yes

Do you have a part exchange machine?(Required)

Yes

If Yes:

Is VAT Applicable?

Yes

Is there outstanding finance remaining on this machine?(Required)

Yes

What will the new machinery do for your business?

Do you have any agreements ending in the next 6 months that you are aware of?

Do you have any other needs that need to be taken into consideration?

Are there any positive or negative factors that you are aware of, or positive or negative foreseeable changes in circumstances that you wish us to take into account in the arranging of your finance?

Please select how you would like to hear from us?(Required)

Phone

Mail

Text

Would you like us to send a copy of any agreements to your accountants?(Required)

Yes

Can you confirm you hold or will ensure arrangement of valid insurance to insure the machinery?(Required)

Yes

Supporting Documentation

Max. file size: 32 MB.