Personal loan request

Your credit

Amount (in €)

Duration (months)

Admin charges (in €)

APR (indicative in %)

Total cost (indicative in €)

Repayment amount (in €)

Purpose of loan

Other

Before accepting this loan application, the Bank reserves the right to ask for coverage with a credit balance insurance from Raiffeisen-Vie

Your personal situation

Title

First name

Last name

Gender

Male

Female

Marital status

Nationality

Birthdate

Day

Month

Year

Place of birth

Country of birth

Postal address

Number

Street

Postcode

Town/city

Country

Do you work in Luxembourg?

Yes

Contact

Phone number

Are you a Raiffeisen customer?

Yes

Do you, or one of your close relatives, hold a political mandate?

Yes

Personal information of the co-debtor

Add a co-debtor?

Yes

Title of the co-debtor

First name of the co-debtor

Last name of the co-debtor

Gender of the co-debtor

Male

Female

Marital status of the co-debtor

Nationality of the co-debtor

Date of birth of the co-debtor

Day

Month

Year

Place of birth of the co-debtor

Country of birth of the co-debtor

Your personal situation

Number of dependent children

Profession

Employer

Former employer

Employer’s country

Type of employment contract

Description of the occupation

Country of occupation

Start date of occupation

Day

Month

Year

Profession of the co-debtor

Employer of the co-debtor

Former employer of the co-debtor

Employer’s country of the co-debtor

Type of employment contract of the co-debtor

Description of the occupation of the co-debtor

Country of occupation of the co-debtor

Start date of occupation of the co-debtor

Day

Month

Year

Monthly income of the household

Net salary (in €)

Pension/annuity (in €)

Alimony received (in €)

Rental collected (in €)

Other monthly income?

Yes

Description of income(s)

Amount of income(s) (in €)

Total monthly income (in €)

Monthly outgoings of the household

Home owner?

Yes

Rent paid (in €) (including service charges)

Repayment(s) on other loan(s) (in €)

Payments into home savings account (in €)

Alimony paid (in €)

Other monthly outgoings?

Yes

Description of outgoings

Other monthly outgoings (in €)

Total monthly outgoings (in €)

Confirmation

I accept the general terms of credit.

General terms of credit

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mandatory fields

Disclaimer

The personal data collected via this form are for the exclusive use of the Raiffeisen group for processing your loan application and may be used for prospecting to provide you with regular information on our products and services.

For more information on the processing of personal data, please consult our Informations Notes on the protection of personal data available on the Bank's website under the heading “Data Protection" .

Complete your loan application online

Your credit

Your personal situation

Postal address

Contact

Personal information of the co-debtor

Your personal situation

Monthly income of the household

Monthly outgoings of the household

Confirmation