Step 1 : Information on the borrower
Step 2 : Description of your project
Step 3 : Your financing plan
Please complete this form carefully and ensure that you provide accurate information about your plans,
to enable your BNP Paribas advisor to suggest the most suitable options.

* Mandatory fields
 Your marital status
 *   * Name : 
   Maiden name : 
 * First name : 
 * Date of birth (DD/MM/YYYY): 
 * Place of birth   * Country of birth 
 Your marital status:
 Matrimonial property regime (if married) :   Joint estate
 Separate estate
 Number of dependent children: 
  Your contact details and address
Current address: 
 * Rue :     * Zip code : 
 * Town : 
 * You are:   Tenant  Owner
 * Home phone  : 
Mobile phone : 
Adresse e-mail : 
 Business information
 * Occupational category : 
 * Occupation : 
 * Name of your current employer : 
 Work phone : 
 * Your employment type  : 
(Permanent contract, fixed-term contract, etc.) 
 * How long have you been with your current employer? : 
  You and your bank
 *  Current main bank : 
 Other : 
  if you are an existing customer of BNP PARIBAS,
please state the name of your branch in the space above 
 *  How long have you been with this bank? 
Next step (with co-borrower) Next step

The information requested on this form is needed to prepare for the appointment with a BNP Paribas Advisor regarding your plans.

Pursuant to the French Data Protection Act (loi Informatique et Libertés) of 6 January 1978, you have the right to access, correct and remove such information through a written request sent to the following address: BNP Paribas Epargne & Retraite Entreprises - TSA 49015 - 75688 Paris Cedex 14 EUR 1,811,390,890 - Registered office: 16 bd des Italiens -75009 Paris - 662 042 449.

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