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If you were refused an application to apply for a farm ownership loan, operating loan or emergency loan, we would we like to hear from you. You may be contacted to obtain additional information.

First Name, M.I., Last Name:  
Address:  
City, State:   , 
Zip Code:   -
Phone Number:   ( ) -
Preferred Call Time:  
 
In (month or season/year)
in (county), (state),
I was refused an application for .
 
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