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Personal information
Spuerkeess customer
*
Yes
No
Preferred Branch
*
Spuerkeess Branch
Ariane
Avenue J.F. Kennedy
Bascharage
B.E.I.
Belval Plaza
Belvaux
Bertrange
Bettembourg
Bonnevoie
Capellen
Centre
Centre Européen
Cents
Clervaux
Cloche d'or
Cour de Justice
Differdange
Diekirch
Dudelange
Echternach
Esch / Alzette
Esch / Nord
Ettelbruck
Gare
Gasperich
Grevenmacher
Hesperange
Junglinster
Kayl
Kirchberg
Knuedler
Leudelange
Limpertsberg
Mamer
Merl / Belair
Mersch
Mondercange
Mondorf
Niederanven
Place de Metz
du Personnel
Pétange
Redange
Sandweiler
Schifflange
Steinfort
Strassen
Walferdange
Wemperhardt
Wiltz
Name:
*
Forename:
*
Date of birth:
*
Format: DD.MM.YYYY
Phone number:
*
E-mail:
*
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