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85 50 55

Loan application

Caution

For your application to be processed, please send:
Identity Card
at the e-mail:
salut@creditrapid.md or on the fax numbers: 45 54 77, 46 89 66.

Individuals

Mandatory fields
 
Applicant
Name, Surname Personal code
 Date of birth
  
Place of residence City
 Street
Numer
 app.
Contacts Home tel.
 Mobile
 Work tel.
 Email address
  
Marital status
single married
Nr. of dependent family members
  
Housing Type
personal property rent with parents mortgage
Land number
  
Car owner Make/model
Production year
  
Employer Current Employer
 Current position
 Employer address
 Total work lenght
 Length at current employment
Field activity Transport and telecommunications Food and catering Health and social care Recreational, cultural and sporting activities
  Trade Services Agriculture Public administration
  Constructions Education Financial activity Other
   
Financig purpose and terms
Purpose Good/service required to finance
Supplier of good/service
 
Car description Make/model
Production year
  
Terms Price of good/service
Requested amount of the loan
 Period
Loan payment date Choose the payment date (any calendar day)
 Application
(fill in only for cars)
personal use commercial use taxi or rent a car
Financial information
Monthly income sources (USD) Salary
 Dividends
 Pension
 Income of other family members
  
  Transfers from abroad
 Rent
 Income from services rendered
 Other income
  
Credits, leasing and active loans of the family and the companies where you have a majority share.
Financial Institution
 Loan Balance
 Currency
 Monthly rate
 Loan purpose
 
Pledged assets
Yes No
Contact person (spouse, parents, children)
Name, Surname Current Employer
 Current position
Contacts Home tel.
 Work tel.
 Mobile
  
Source of information

I certify that all information provided on this application and attached documents are true, correct and complete. I am informed that false statements, theft and obtaining credit by fraud are punishable under Art. 190, art. 238 and art. 361 of the Penal Code. I understand that the Company may refuse this request without being obliged to give explanations as to why that decision was made.

Durind signing the contract and its duration, Credit Rapid Company has the right to check the data from the application, within the existing legislation.

Date
Signature:
Enter the code shown in the picture
 
Mandatory fields
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