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Updated: 20.07.2012 14:17
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Converse Collection
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Financial System Mediator
01.05.2013 - 31.05.2013
AMD - 11.00
USD - 7.00
Credit limit revision application
Bank book application
Payment order cancellation
Payment order revision
Service charge application
SMS balance statement application
Online account statement application
Online account-management application
Cash checkbook application
Utility billing application
Cash-backed loan, credit line and overdraft application
Payment card application
Gift card application
Credit limit revision application
Credit limit revision application
Card holder personal data
In Armenian, as in the passport
Name*
Last name*
Middle name*
Passport information
Serial *
Number *
Issued*
Card number*
Please change
Loan limit amount*
Personal Data
As in Passport
Name*
Last name*
Middle name*
 
Passport information
Serial *
Number *
Issued*
 
Current address
Region*
City *
Postal Code*
Street*
House*
Apartment*
 
Permanent address (leave blank, if it is the same)
Region
City
Postal Code
Street
House
Apartment
 
Phone numbers. e-mail
Home*
Work
Mobile
E-mail
 
Employment info*
Other
Company name*
Company address*
Current position*
Employed since*
Net monthly wage (in AMD)*
other incomes(in AMD)
Other income sources
Phone number *
Fax
E-mail
 
other information
Send Monthly Statement to*
Other address
If the amount exceeds
send SMS about transaction
Password (no less than 6 characters )*
Repeat password*
 
Automatic payment
Account number
 
Information concerning the family
Marital Status*
 
Information about account is other banks
Bank name Account type Bank System Account creation date
Information about loans
Bank name Loan type Loan amount (in AMD Interest rate Monthly repayment amount Loan creation and due date Order
Please key-in the displayed symbols*   
  
Fields marked with an * are required.
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