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Edwin Popovitch - Yves Rigaux
CBFA insurance brokers: 40086A
CBFA credit brokers: 045740A

CEPIAC, a company formed by E. Popovich and Y. Rigaux provides you with help and advice on all matters related to mortgage products.
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Credit
Study

Please complete this questionnaire and we will reply as soon as possible.
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Recovery
Study

Please complete this questionnaire and we will make you a recovery offer as soon as possible.
>> Read more

 

Please remember that our interventions are paid by credit institutions.
They are therefore free transactions for you and made independently from those institutions. Some fees are charged by credit companies. They will be explained to you before any introduction of file.

 

puceRecovery Study

 

T h a n k  y o u  f o r  y o u r  t r u s t

Please complete this questionnaire and we will make you a recovery offer as soon as possible.

A: requestor

One borrower             Two borrowers

Last Name borrower  (mandatory)

First name borrower  (mandatory):

Borrower date of birth (mandatory):

Address (optional):

Zip code (optional):

Locality (optional):

E-mail (optional):  

Private phone (advised):

Office phone (advised):

GSM (advised):

e-mail (advised):

The name of your insurance broker:

Purpose of the credit (mandatory):

Purchase region:

Number of children (mandatory):




B: Characteristics of the current loan

Registered loan:

as individual

as company

Lender (mandatory):

Loaned amount (mandatory):

Initial duration (mandatory):

Rate type (mandatory):

Rate (mandatory):
months

Rate type (mandatory):

Repayment mode:

Date of the first repayment in capital (construction) (mandatory)

Balance registered on your last tax return (mandatory):

Purpose of the loan:

Current value of the good (mandatory)

Is a new borrowing requested in addition to the recovery (mandatory):   No    Yes


Your can also print this form from your browser and send it to us via fax at 02/779.11.85

 


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