Credit Release Form

The applicant designated as “lessee” in the foregoing application hereby authorizes all banks, financial institutions, trade reference sources, credit reporting agencies and others to release credit information (including but not limited to D & B reports and credit bureau reports) concerning applicant. A photocopy or facsimile copy of this authorization shall be valid as the original.




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Printed Name of Applicant (Company)

By: ___________________________________
(Printed Name of Information Source)

Title: __________________________________



CREDIT RELEASE: By signing below, the undersigned individual(s), who is/are either a principal of the credit applicant (designated as “Lessee” in the foregoing application) or a personal guarantor of its obligations, provides written instructions to assignee or potential assignee thereof authorizing review of his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the credit application represented by the foregoing application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for the reviewing or collecting the resulting account. A photocopy or facsimile copy of this authorization shall be valid as the original.

By signing below, I/we affirm my/our identity as the respective individual(s) identified in the foregoing application.


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Signature Signature
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Printed Name Printed Name
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Date Date