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* 1. Name

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* 2. Address

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* 3. Email address

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* 4. Phone Number

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* 5. When did you purchase your home?

Date

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* 6. Who is your Home Loan currently with?

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* 7. Who do you use for your primary banking relationship? Checking, Savings, etc.

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* 8. Are you happy with your current bank?

T