Personal Loan Application Form Page 4

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Personal loan application form
(
Available to French residents only)
Terms and conditions/ Declaration
I / We declare that:
- The information given above and in any attachment, in particular the description of other loan commitments,
level of income and property, is true and accurate and is to be regarded as forming part of any subsequent
contract with the lender (and the insurers) and acknowledge that I / we will be liable for any loss suffered by
them as a result of reliance upon my / our statements.
- I / We certify that the loan requested will not lead to a debt which is out of proportion with my / our income.
- I / We authorise any enquiries considered necessary for the confirmation of the above particulars and for
credit assessment.
- I / We authorise the lender to disclose to Crédit Agricole, their representatives, or their Solicitor, such
information as they may request concerning any existing or previous accounts, including redemption details.
- I / We authorise the disclosure of any information relating to this application to the other applicant(s), credit
reference agencies and to any other person acting on behalf of the lender.
- I / We appreciate that this application may be declined without a reason being stated.
SIGNATURE OF APPLICANT(S):
1-……………………………………………………………………………
Date………………………………..
2-……………………………………………………………………………
Date………………………………...
Please return this application form to:-
CA BRITLINE
15, Esplanade Brillaud-de-Laujardière, CS 25014
14050 CAEN Cedex 4 France
(1)
(1)
Tel: 00.33. (0)2.31.55.67.89
Fax: 00.33. (0)2.33.72.54.72
(2)
E-mail :
britline.mortgage@ca-normandie.fr
Web site :
(1)Local costs apply when phoning within France from a fixed line. Check with your service provider when calling from abroad.
(2) Free access by internet (excluding fees charged by your service provider).
Thank you for the time taken to complete this application.
4/4
Caisse Régionale de Crédit Agricole Mutuel de Normandie - Head Office: 15,esplanade Brillaud-de-Laujardière, CS 25014 ,14050 CAEN
CEDEX 4.Cooperative company with variable capital, registered as a credit company - 478 834 930 RCS Caen - Insurance brokerage
company registered under matricule Nr 07 022 868.
Inter-European VAT number: FR 83 478 834 930. Crédit Agricole Britline is a member of the Guaranteed Fund for deposits,the Guarantee
of Investors warranties, and Guaranteed Fund for investors. Crédit Agricole Britline is controlled by L’Autorité de Contrôle Prudentiel et de
Résolution: 61 rue Taitbout – 75436 Paris Cedex 09

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