Vendor Information Form

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.