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LOAN SEEKERS APPLICATION FORM ****************************** 1) Full Name: 2) Gender: 3) Loan Amount Needed: 4) Loan Duration: 5) Country: 6) Home Address: 7) Mobile Number: 8) Fax Number: 9) Occupation: 10) Monthly Income: 11) Salary Date: 12) Purpose of loan: 13) Where did you get our loan advertisement: ushaservicesonline@gmail.com