Page 14 - BRITELITE PRESENTER FEB19

Superstructure Satisfaction Note:

Customer Satisfaction Note

2 Apex View, Leeds,
Supplier LS11 9BH
Name :Britelite Tel: 0344 3755515
Fax: 0113 3801158
Email: paymentrequests@hitachicapital.co.uk
Number:

Agreement Authorisation
Number:

Customer

Title: Mr/Mrs/Miss/Ms.Other Forenames: Surname:

Address:

Postcode:

Telephone Number: Email Address:

Customer Declaration
(To be completed below by the agreement signatory authorised above)

Description of Goods:

I can confirm that the installation of my conservatory/extension/orangery (base, frames, roof, and glazing) has
been completed to my satisfaction and I hereby authorise Hitachi Personal Finance to release the amount of
credit to the retailer

Signed: Date:

Print Name:

Hitachi Personal Finance is a division of Hitachi Capital (UK) PLC
Hitachi Capital (UK) PLC is authorised and regulated by the Financial Conduct Authority
This document is for internal purposes and not to be shown to customers