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Release Of Credit Information

Dear _________:

Enclosed is a photocopy of Mr. Smith's signed authorization for disclosure of credit information. Would you be kind enough to supply the information requested below? We have provided you with a copy of this request for your files. Please return the original in the enclosed, postage paid envelope.

Name of Applicant: __________________________________

Address: __________________________________

City, State, Zip: __________________________________

Length of time of Credit Account:

Highest Credit Extended:

Credit Limit:

Average Monthly Balance:

Balance Now Due:

Balance Past Due:

Normal Paying Habits:

Remarks: