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____________ 4. Loan Amount Requested up to $300: $ ______________ 5. Enrollment Number: _______________________ 6. Social Security Number: _______________________ 7. Date of Birth: _______________________ Print Name: ___________________________________ Signature: ___________________________________ _____ Mail _____ Pick Up Little Wind Loans: ___________________________________ Aaron Wallowing Bull, Manager Approved Date: _________ Denied Date: _________ .

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