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Ase fill in all the information in Part C & D Accurately LOAN APPLICATION & AGREEMENT FORM INDEX NO: / CO-OP NO: Date Loan Application No PART A 1. Applicant s full Names as per National ID Card/Passport 12. Repayable in months 13. Contribution/month for FOSA loan 2. National ID No/Passport No 14. Purpose for which loan is a.

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