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CONSOLIDATED FINANCE COMPANY LIMITED PROPOSAL FOR INSURANCE PREMIUM FINANCING
 
Full Name:
Date Of Birth:
ID:
Address:
Telephone (h):    (w):    (f):
Current Employer:
Address:
Occupation: Length:
Gross Salary : $   Expenses: $   Disposable Income: $
Banker:
Address:
Insurance Company:
Class of Insurance:
Vehicle Financed:     Yes    No Mortgagee:
Payment Options:     Post Dated Cheques     Standing Order     Salary Deductions
 

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