STEP 1 of 2

Contact Information

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Date of Birth *

Social Security Number *

Authorization

By checking the box, each undersigned individual(s), who is either a principal of the credit applicant listed above or a personal guarantor of its obligations, provides written instruction to TCEC or its designee (and any assignee or potential assignee thereof) authorizing review of his or her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the credit applicant and subsequently for the purpose of update, renewal or extension of such credit and for reviewing or collecting the resulting account. Applicant also agrees to allow email or text notifications and updates. A photostatic or facsimile copy of this authorization shall be as valid as the original. Check the box to agree to the terms above.

Signature

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