Please complete the form below and submit it for consideration of your vehicle to be prosposed for a Hire Purchase loan.

M/S Sri Vijayaram Hire Purchase and Leasing Finance Private Limited
14, Thayumanavar Street,
Salem Dist.
Type of body: 
Engine No: 
Chassis No: 
Registration No: 

1. Name in Full: 
2. Father's or Husband's Name: 
3. Permanent Postal Address: 
4. Business Address: 
5. Nationality: 
6. Age: 
7. Are you at present employed and if so since when and where?: 
8. Where you were previously employed and if so give full details?: 
9. Are you in business yourself and if so give full details?: 
10. Income(monthly): 
11. Income(other than monthly): 
12. When received?: 
13. Have you an account with any Bank and if so which Branch?: 
14. Give location, extent value and nature of any land and houses or any other property you own: 
15. In the above your sole and absolute property any if not state who else has interest in that property?: 
16. Is the above property or any portion of it encumbered in any way?: 
17. Are the title deeds in your possession not who has them?: 
1. With whom you had credit dealing?: 
2. With whom you had a H.P. contract?: 
3. Personal: 
19. If bus, state limits of route: 
20. If lorry, for whom contracting: 
21. If Taxi, location of stand: 
22. If Private Car garaged at: 
23. How much on an average do you expect to earn from this vehicle?: 

Email Address:

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