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Loan amount

Loan duration

Credit guarantee Yes No

Title Mr. Mrs.

Name

First name

Date of birth

Street / Number

Postal code/Town

Net monthly salary

Ongoing prosecution or seizure

Amount

Marital status

Nationality

Phone number

ex. 079 433 33 33

Email

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I hereby confirm having read the terms of use in full and declare accepting all terms.

I agree that Milenia can process my credit application with the banks in Switzerland and provide me an offer without commitment.