贷款种类：_____________________________________________

　　合同编号：_____________________________________________

　　贷款人：___________________________________________银行

　　住所：_________________________________________________

　　联系电话：_____________________________________________

　　传真号码：_____________________________________________

　　借款人：_______________________________________________

　　工作单位：_____________________________________________

　　家庭住址：_____________________________________________

　　联系电话：_____________________________________________

　　还款账号：_____________________________________________

　　保证人：_______________________________________________

　　住所：_________________________________________________

　　通讯地址：_____________________________________________

　　电话：_________________________________________________

　　存款金融机构及账号：___________________________________

　　传真号码：_____________________________________________

　　出质人：_______________________________________________

　　住所：_________________________________________________

　　通讯地址：_____________________________________________

　　电话：_________________________________________________

　　开户金融机构及账号：___________________________________

　　传真号码：_____________________________________________

　　抵押人：_______________________________________________

　　住所：_________________________________________________

　　通讯地址：_____________________________________________

　　电话：_________________________________________________

　　开户金融机构及账号：___________________________________