Credit Application Release Of Information

This agreement is used so that a party can obtain credit information concerning another party.

AUTHORIZATION FOR RELEASE OF INFORMATION

Name of applicant:

Social security number:

Date of application:

TO: Employers, Credit References

You are authorized to release information concerning my employment or credit history with you to [Company], Inc..

You are further released from liability in connection with your response to this inquiry.

A photocopy of this authorization will be as effective as an original.

__________________________

Signature

[Company], Inc.

Attention:

Posatl Address:

City:

State: Zip:

Telephone: