INFORMATION TO PROVIDE TO A LOAN APPLICATION

Name:……………………………………………………………………

First names :…………………………………………………………………

Home address of residence …………………………………………

City: …………………………………………………………………………………………

Country : ……………………………………………………………………………………………

Zip code : ………………………………………………………………………………………

Date and place of birth :……………………………………………………………………………

Landline / mobile : …………………………………………. /………………………………………

E-mail: …………………………………………………………………………………………………………

Profession : ……………………………………………………………………………………………………

Desired loan amount : ………………………………………………………………………………………

Duration of repayment: ……………………………………………………………………………………..

Monthly income : ……………………………………………………………………………………………………..

Interest rate : ………………………………………………………………………………………2%

Smoker :………………………………….Yes…./NO…….(
It is for the purpose of insurance
)

In the event that your application would be accepted, be aware that all the information provided above must be justified before the transfer of funds to your account.