I/We acknowledge receipt of notice in compliance with the Federal Credit Opportunity Act. The foregoing application has been carefully read and is in all respects complete, accurate and truthful. This Application is made
to Your Company Name Here for the purpose of obtaining credit from you, or as a basis of credit for future
business, the following complete statement is made: It is agreed that I/We will notify you promptly, should there be any material change in my financial condition or financial condition of the business. I understand that I will be responsible for all collection costs should I default on my payment. This application is given for your sole use and information and is not to be divulged or used by anyone else provided, however, that the undersigned herby authorizes the named bank(s), trade and/or other reference(s) to release such information as is necessary to
establish credit with you. The undersigned, a guarantor, hereby authorizes and consents to Your Company Name
Here requesting my credit report.