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AFTP Contact Sheet

Date of Call Info / Application Sent (circle one)

1) Potential Borrower :

Address :

County of Residence :

Phone Number / email:

2) Person with disabilities (if different) Name :

Age Disability

Address :

County of Residence :

Phone Number / email :

AT needed Estimated Cost

3) Name of Caller (if different)

Address :

Phone Number / email :

How would you like to receive the information/application? Standard print Large print

By email Other

How Did You Hear About PATF?

Outcome

Application Received Items need, if incomplete

Amount of Loan Request Estimated Monthly Payment

Application Complete Faxed to Bank

Guarantee Requested Yes No (attach copy of reply from Bank)

Board Review Date / Results

Notified FUNB (attach copy)

Withdrawn / Denied (reasons)

Borrower Notified (attach copy)

 

 

 

 

 

 

Notes

 

Follow-up Contacts

 

 

 

 


AFTAP/RESNA
1700 North Moore Street, Suite 1540
Arlington, VA 22209-1903
Phone: 703/524-6686  Fax: 703/524-6630  TTY: 703/524-6639
Email: info@resna.org  http://www.resnaprojects.org/AFTAP

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