CREDIT REPORT AUTHORIZATION FORM

Authorization is hereby granted to Gazette Mortgage, to obtain a consumer credit report through a credit reporting agency chosen by Gazette Mortgage. I understand and agree that Gazette Mortgage intends to use the consumer credit report for the purposes of evaluating my financial readiness to obtain a loan.

I, _____________________________ on __________________ authorize Gazette Mortgage to pull my credit as part of my application for a mortgage loan. I understand that if my credit is pulled without my SSN, the resulting report may not be complete or accurate, so it is in my best interest to provide my SSN for the purpose of this inquiry on my credit.

I understand that this credit report will be retained on file at the Gazette Mortgage office for use only by Gazette Mortgage staff. This information will not be disclosed to anyone by Gazette Mortgage without my written consent.

Furthermore, I understand that, should I choose to apply for financing through Gazette Mortgage, a revised credit report costing an additional fee may be required.

My signature below authorizes the release to the credit reporting agency of financial information which I have supplied to Gazette Mortgage in connection with such an evaluation. Authorization is further granted to the credit reporting agency to use photostatic reproduction of this form if required to obtain any information necessary to complete my consumer credit report.

CHECKING THE BOX BELOW GRANTS PERMISSION FOR THE RELEASE OF FINANCIAL INFORMATION TO THE CREDIT REPORTING AGENCY AND GRANTS PERMISSION FOR Gazette Mortgage TO OBTAIN A COPY OF YOUR CREDIT REPORT.