Print This Page, Complete The Form And Fax To 334-215-4437 To Whom It May Concern Please accept
my authorization and approval to release any and all credit information to
Autrey Capital Group, LLC ( “APA” ) and to various lending sources and/or
bonding companies as determined by APA for the purpose of deciding whether, or
not to extend credit to the undersigned. The credit information includes, but
is not limited to information obtained from various credit bureaus, Dun &
Bradstreet, banks, finance companies, bonding companies, employers and trade.
This includes method of payment, credit terms, length of credit history, high
credit, current balance, work in process and collateral description. Company Name (If applicable)____________________________________________________ FIN
(If Applicable)_______________________________________________________________ Print Name____________________________________________________________________
Signature______________________________________________________________________ Social Security Number_________________________________________ Date_____________ |