Apply for Finance on the Mirage 125

£2,499.00

To apply for finance, simply enter your details below and one of our experienced sales team will get back to you and discuss the various options available to complete the process.

Please note - If you are further than 30 miles from our postcode please call for more information.

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View Mirage 125

Required fields are marked with a *

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Bike Details

Bike Model:
Mirage 125

Bike Price:
££2,499.00

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Personal Details

Full Name (as it appears on your Driving Licence)*: required.

Home Phone Number*: A valid phone number is required.

Mobile Phone Number*: A valid phone number is required.

Daytime Phone Number*: A valid phone number is required.

Email Address*: A valid email is required.

Date of Birth (mm-dd-yyyy)*: A valid format is required. (mm-dd-yyyy).

Status*: Married Single Divorced Separated

Accommodation details*: Home Owner Tenant Living with Parents Other

Number of Dependants (ie. Children under 18)*: A valid number is required.

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Address Information

Current Address

House number / name: required.

Road: required.

Town: required.

Postcode: required.

Time at Address year(s):

Years: A valid number is required.

Months: A valid number is required.

Does your driving license show this address: Yes No

Please tick box if time at current address is less than 3 years:

2nd Address

House number / name: required.

Road: required.

Town: required.

Postcode: required.

Time at Address year(s):

Years: A valid number is required.

Months: A valid number is required.

Please tick box if time at current address and 2nd address is less than 3 years combined:

3rd Address

House number / name: required.

Road: required.

Town: required.

Postcode: required.

Time at Address year(s):

Years: A valid number is required.

Months: A valid number is required.

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Employment & Occupation Information

Employment Status*: Employed Self Employed Retired

Occupation*: required.

Employers Name: required.

Time in current Employment

Years*: 0 1 2 3+

Months*: 0 1 2 3 4 5 6 7 8 9 10 11

Work Address Property No* required.

Road*: required.

Town*: required.

Postcode*: required.

Work Phone No*: A valid phone number is required.

Previous employers details (If Less than 3 yrs):

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Banking & Deposit Information

Please fill in the information below regarding your finance request. We will contact you to request your banking information upon receipt of the completed form.

Amount of Deposit (£)*: A valid number is required.

Loan Required (£)*: A valid number is required.

Term*: 12 Months 18 Months 24 Months 30 Months 36 Months 42 Months 48 Months 54 Months 60 Months

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Send Information

Would you be willing to proceed providing the application is successful:

Please select: Yes No