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Retail banking

Application on-line

Please, consider my preliminary application for Car Loan.
* Region:
Branch:
Wishful autosalon:
Mark auto:
* Cost auto: rubles
Insurance:
* Initial payment(min 10%): rubles
* Loan amount
(from 30,000 to 2,250,000 rubles):  rubles
* Credit period:  mounths
* Kind of auto:
Personal Information:
* Last name:    * First name:    * Middle name: 
Citizenship: resident nonresident
* Date of birth:       19
* Place of birth: 
Passport:  * series   * number 
* issued by
* date
Driving licence:
 * series   * number 
* issued by
* date
Address of registration:
Region:
Area:
Street:
  House: Building: Apartament:
Type of address:
Address of living:
* Please contact me at telephones (office and home should be fixed/stationary phone):
mobile:
office:
home:
Contact person:
Name:
Date of birth:
Phone (shoul be fixed/stationary phone):
Social status:
Education:
Family:
Name:
Child count:
Work company:
Company name:
Employment type:
Position:
Seniority type:
Seniority:
Amount:
Address of work:
Region:
Area:
Street:
  House: Building: Apartament/office:
Code on picture
 
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