TO:__________________________

Re: Loan #______________or Savings Account #____________,

I hereby authorize release to ___________________________,
credit information for my pending credit application on a
real estate transaction.
________________________
Signature

Loan Opened________________ Monthly Payments___________
High Credit________________ Current Balance____________
Paying Record____________________________________________
Savings Account:
Date Opened______________ Present Balance_____________
The above is furnished to you in strictest confidence to
your request.

Date:_______________________ _______________________
By__________________________ By_______________________