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Nos. 455-1086 / 376-6397 / 0932-8675543 to 45 / 0917-8454789 APPLICATION AND EVALUATION FOR LOAN Accomplish one (1) Copy Only Application No. Gentlemen: The undersigned, a member of this Association, respectfully requests for a Loan in the amount of PESOS ( ) under the terms and conditions stipulated in the Association's Promissory Note. It is understood that the loan is subject to all regular and legal charges.

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