Credit-Release

Full Name*

First and Last
Business Name*

Full Legal Business Name
Address*
Street Address Address Line 2 City State ZIP Code
Social Security Number*
Numbers Only Please
Signature that: Applicant hereby authorizes CRDfinancial, its nominees or assigns ("Lessor"), to check Applicant's credit and bank records, and specifically authorizes all of its bankers and creditors to release to Lessor any information Lessor requests. By signing below, the undersigned individual(s) authorizes Lessor to review his/her personal credit profile from any commercial credit bureau for the purpose of extending or renewing any credit facility, or to collect the resulting account. A photostat or facsimile copy of a photostat or facsimile copy of this authorization is valid as the original. By signing below, I/we affirm our identity as the respective individuals identified in this application. Individual(s) signing below also hereby affirm that Applicant wishes to utilize CRD Financial and no other brokers with respect to the above listed equipment.*
Name
This field is for validation purposes and should be left unchanged.