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LOAN/APPLICATION REGISTER Page of Name of Reporting Institution City State Zip Application or Loan Information Loan Number Date Received mm/dd/ccyyy Form FR HMDA-LAR Agency Reporter s Identification Number Code Action Taken Type Purpose Owner Occupancy Loan amount in thousands Applicant Information A Applicant CA Co-Applicant Property Location FourDigit MSA Number TwoDigit State ThreeDigit County Race or National Origin Gross Annual Income Sex Si.

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