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         © 2007 Land Bank South, FLCA
 


Contact Form

If you would like us to contact you regarding a loan application, please provide as much information below as possible. A Land Bank association representative will be in contact with you within 24 hours (48 hours if submitted on Saturday) to discuss your needs.
   
Name:
Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
E-mail Address:

Purpose of loan: (choose one or more)
Land Purchase
Home Purchase
Homesite Purchase
Home Construction
Other Construction
Refinance
Other
Number of acres being purchased or refinanced:

County in which property is located:

Nearest town:

Purchase Price (if applicable): $

Loan amount requested: $

How did you find us?

Newspaper
Radio
Television
Brochure
Internet Search Engine
Direct Mail
Loan Officer Contact
Referral
Other
Questions or comments:

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