Application for the payment of the guaranteed compensation

Information about application

Please authenticate, because the application is only for Luminor customers!

Date (filled automatically)*

I apply as:

Name*

Surname*

Personal identity number*

Personal identification document number*

Declared address of residence *

Postal address, if differs from legal address

Postal address differs from legal address

Postal address (street, No., city, postcode)*

Company name*

Company registration number*

Legal address*

Postal address, if differs from legal address

Korespondences adrese atšķiras no juridiskās adreses

Postal address (street, No., city, postcode)*

E-mail*

Phone*

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