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MCH CARE Collateral Agreement Form

Prepared for:
Client.FirstName:………………………………………………………………..
Client.lastname:………………………………………………………………….
Client-loan amount in total…………………………………………………
Client NRC number……………………………………………………………..
Client phone number…………………………………………………….…….
Client tentative number………………………………………………….…..

COLLATERAL COLLECTED

Name of the item collected 1………………………………………………..


Worth of the item collected 2……………………………………………….
Name of the item collected 1………………………………………………..
Worth of the item collected 2……………………………………………….
Worth of the item collected…………………………………………….….…
Borrower signature………………………………………………………….…...
Company representative signature……………………………………..…
Witness name …………………………………………..NRC……………….…..
Balance ……………………………………………………………………………...…

Collateral is only required when one defaults (fails to pay within the
agreed time).
Items collected will be sold (in default) after 30 days without
consulting the defaulter.
Date signed ………………………………/……………………………../2022

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