借款人：______________________________________
住所：________________________________________
身份证号码：__________________________________
电话：________________________________________
邮政编码：____________________________________
开户银行及账号：______________________________
长城卡卡号：__________________________________
有效期：______________________________________
贷款人：______________________________________
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法定代表人(或授权委托人)：__________________
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借款人(以下称甲方)：________________________
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