CREDIT REPORT AUTHORIZATION FORM

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

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

Furthermore, I understand that, should I choose to apply for financing through Coast to Coast Financial Enterprises, 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 Coast to Coast Financial Enterprises 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 Coast to Coast Financial Enterprises TO OBTAIN A COPY OF YOUR CREDIT REPORT.