Monday, March 28, 2005



Re: Loan #______________or Savings Account #____________,

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


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_______________________


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The forms are samples provided for discussion purposes only. Should you decide to use any of them in your business or personal activities, it is advised that you have them reviewed by competent legal counsel.