Xavier G-Cash Loan Form

Xavier's G-cash Loan Form
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I agree that I have read, understood and accepted our G-Cash Loan Terms and Condition.*

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Full Name*

First NameMiddle NameLast Name
Cell Number:*
G-Cash Number:*
Personal E-mail:*
Online Shop E-mail:*
Personal FB Account:*
URL
Online Shop FB Account:*
URL
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
One Facebook Account of your family or relatives:*
and your Relationship:*

ID's and Photo's
ID # 1:*

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ID # 2:*

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Photo Holding the two ID's:*

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Proof of Document:*

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ex. Birth Certificate, Marriage Certificate, etc Cancelof
Proof of Billing:*

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ex. Meralco Bill, Broadband Bill, etc Cancelof
Proof of Shipment:*

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Xavier's G-cash Loan Form