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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Guarantee Requested Yes No (attach copy of reply from Bank) Board Review – Date / Results Notified FUNB (attach copy) Withdrawn / Denied – (reasons) Borrower Notified (attach copy)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
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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 |