AUTHORIZATION TO RELEASE INFORMATION

   

I/We hereby authorize you to release to

THE MONEY BROKERS, INC. for verification purposes information concerning:

 

          Employment History

 

          Checking and Savings Accounts

 

          Mortgage and/or Landlord Ratings

 

          Any and all other information required for the purpose of a credit transaction

  You may accept a photocopy or facsimile of this signed authorization in lieu of the original.

Your cooperation will be greatly appreciated.

   

________________________________                                _________________________

Signature of Applicant                                            Date

   

________________________________                                _________________________

Signature of Applicant                                            Date