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Questions or Comments:
In submitting this inquiry, I certify
that all information provided is true and accurate. Applied Bank may keep this
inquiry and information. I understand and agree that by submitting this inquiry,
neither I nor Applied Bank is committing to open an account, extend credit or
render any service. This inquiry is submitted for the sole purpose of a Applied Bank
Representative contacting me, as indicated below, in order to further
discuss the account I have indicated above.
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