AUTHORIZATION TO RELEASE CREDIT INFORMATION
From: ________________________ To:
Thank you for your interest in establishing credit
with our company. Enclosed is an
authorization to release information.
Please sign the agreement below and complete the
enclosed form. The enclosed form as
well as your most recent financial statements are necessary documents to
complete your application. Upon receipt
we will contact your credit and bank references. Then we will contact you regarding your credit terms with our
I/We authorize the investigation of my/our firm
,_____________________ and its related credit information. I/We have been requested to provide
information to _____________ for their use in reviewing our creditworthiness.
I/We authorize the release of any and all
information obtained during this credit search. I/We release any and all claims and liabilities against any and
all parties involved with regards to the release of this information.
This form is valid for a period of thirty (30) days
from the date below.
Signature ___________________ Signature
Title _______________________ Title
Date _________________ Date
Please keep a copy for your future reference. Thank you.