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This form is not required, but is a convenience in clarifying the supporting documentation the state is required to submit to the U.S. Small Business Administration when requesting an Economic Injury Disaster Loan Declaration. This information in any other format would also be acceptable. For your convenience, this form may be filled our electronically or manually. Please submit completed forms to MaryThomas@countyofglenn.net or fax to (530) 934-6463