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  Personal data
*Name:
*Surname:
*Social Security Number:
Marital status: single married divorced widow
No. of dependents:
  Contact information
*Address (street/ house/apartment)
*City/county: *Postal code:
*Phone: *E-mail:
  Application conditions
*Credit amount: *Credit deadline in months:
*Bank name: *Account no.:
  Loan guarantee
*Guarantee aadress:
*City/county:
*Guarantee value:
*Guarantee description:
Property no.: Property name:
*Guarantee owner:
Debts burdening the guarantee:
I hereby declare that all of the information presented on this application is correct*
  * required fields