Working hours with customers on 20.04.2017

For what type of loan would you like to apply for:---mortgage loanconsumer loan overdraft loancredit card

PIN (Personal Identification Number)

Full name

Age (years):

Family status---MariedSingleDivorced

Number of family members:

Of which children under the age of 18 years:

Home address:

The estate in which you live in---ownacquired through a mortgage loanrented

How long have you lived at the stated address (years):

Education status:---elementary school graduatehigh school graduateuniversity graduate

Employment sector---publicprivate

How long have you worked for your current employer (years):

Do you personally own a vehicle:---YesNo

Do you personally own a real estate:---YesNo

Official monthly income of the household:

Official monthly personal income:

Total amount of monthly financial liabilities to creditors of the household (incl. liabilities for credit cards, consumer loans, financial leasing, mortgage loans, etc.):

Total amount of monthly financial liabilities to creditors of the loan applicant (incl. liabilities for credit cards, consumer loans, financial leasing, mortgage loans, etc.)

Cell phone number:

E-mail address:

Preferred contact time:

Are you currently a customer of Investbank?:---YesNo

By submitting this application I hereby declare the following:
· I am already familiar with the General Terms and Conditions of Investbank JSC for Providing Loans to Individuals, with the Terms and Conditions, Interest Rates, Fees and Commissions applied by Investbank JSC to Individuals as well as with the procedure for granting loans and I agree they shall be applied for the granting, utilization, collaterization and repayment of the requested loan.

· I give my consent that the Bank shall require and receive from any other personal data administrator under the Law for Protection of the Personal Data (LPPD), including, but not limited to the National Social Security Institute, tax administration institutes, BNB registers, information on personal data, declared by me to the Bank, as an individual who is or plans to become a party in an agreement with Investbank JSC, under or regarding obtaining a loan, to the full fulfilling my obligations towards the Bank. I empower the Bank to act as my proxy under the LPPD.

· With this application I hereby agree that Investbank JSC shall process and transfer the personal data received by me to third parties, processing data in the country and abroad for the needs of its banking activity and bank control.

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