Credit Check Authorization Form

In the case of wanting to authorize a credit card, the following form has to be completed and submitted.

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Authorization is hereby granted to _____________________ to obtain a standard
factual data credit report through a credit reporting agency chosen by ___________ .
My signature below authorizes the release to the credit reporting  agency a copy of my credit  application,  and authorizes the
credit reporting agency to obtain information regarding my employment,  savings accounts, and  outstanding credit accounts
(mortgages, auto loans,  personal loans,  charge cards,  credit unions,  etc).   Authorization  is further granted to the reporting
agency to use a photostatic reproduction  of  this  authorization  if necessary  to obtain any  information  regarding  the above
mentioned information.
Applicants hereby request  a  copy  of  the  credit  report  obtained  with  any  possible  derogatory  information be sent to the
address of present residence, and holds ______________ and any credit
reporting organization harmless in so mailing the copy requested.
Any reproduction of this credit report authorization and release made by reliable means (for example, photocopy or facsimile)
is considered an original.
Borrower's SignatureDateBorrower's SignatureDate
Borrower's SignatureDateBorrower's SignatureDate
Form CRAR (03/95) GENESIS 2000, INC. * V9.3/W11.0 * (818) 223-3260