Broker Information

Officers or Principals

If Less Than 2 Years in Business

Business Checking Account

Funding Source References

To whom it may concern:

This will be your authority and my request for you to release to Madison Capital, LLC and/or its assignees, any information they may request concerning credit standing with your company and/or money on deposit. I hereby further authorize Madison Capital, llc and/or its assignees, to obtain any available personal credit bureau reports, as well as bank and trade references, and utilize photocopies of this release in conjunction with the credit application process.

Sending