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INFORMATION AUTHORIZATION DISCLOSURE
THE UNDERSIGNED INDIVIDUAL, RECOGNIZING THAT HIS OR HER INDIVIDUAL CREDIT HISTORY MAY BE A FACTOR IN THE VALUATION OF THE CREDIT OF THE APPLICANT, HEREBY CONSENTS TO AND AUTHORIZES DOSTAL EQUIPMENT & FINANCIAL INC AND ANY ASSIGNEE, LENDER OR FUNDING SERVICE THAT MAY BE UTILIZED TO OBTAIN AND USE A CONSUMER CREDIT REPORT ON THE UNDERSIGNED, NOW AND FROM TIME TO TIME, AS MAY BE NEEDED IN THE CREDIT EVALUATION AND REVIEW PROCESS AND WAIVES ANY RIGHT OR CLAIM THEY WOULD OTHERWISE HAVE UNDER THE FAIR CREDIT REPORTING ACT IN THE ABSENCE OF THIS CONTINUING CONSENT.
THIS REQUEST SHALL ALSO INCLUDE PAYMENT HISTORY AND CREDIT BALANCES FOR TRADE REFERENCES AS WELL AS BALANCE ON DEPOSIT AND BANK/LOAN REFERENCES. I HEREBY AUTHORIZE ANY PHOTOSTATIC COPIES OF THIS AUTHORIZATION.
SIGNATURE _____________________________________
EQUAL CREDIT OPPORTUNITY ACT
APPLICATION NO:
PROPERTY ADDRESS:
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against creditapplicants on the basis of race, color, religion, national origin, sex, marital status, age (provided
the applicant has the capacity to enter into a binding contract); because all or part of the
applicant's income derives from any public assistance program; or because the applicant has in
good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency thatadministers compliance with this law concerning this company is the Federal Trade Commission,Pennsylvania and 6th Street N.W., Washington, DC 20580
We are required to disclose to you that you need not disclose income from alimony, child supportor separate maintenance payment if you choose not to do so.
Having made this disclosure to you, we are permitted to inquire if any of the income shown onyour application is derived from such a source and to consider the likelihood of consistentpayment as we do with any income on which you are relying to qualify for the loan for which you
are applying.
(Applicant) (Date) (Applicant) (Date)
(Applicant) (Date) (Applicant) (Date)
CALYX Form Ecoa.hp 4/95
