Mortgage Los Angeles California

CREDIT REPORT AUTHORIZATION AND RELEASE

Authorization is hereby granted to Allstate Bancorp Inc to obtain a standard factual data credit report through a credit, reporting agency chosen by Allstate Bancorp Inc.

By submitting this form, I authorize the release to the credit reporting agency a copy of my credit, application, and authorizes the credit reporting agency to obtain information regarding my past and present employment earnings records, savings account, and outstanding credit accounts (mortgages, auto loans, personal loans, charge cards, credit union, etc). Authorization is further granted to the reporting agency to use a photo static reproduction of this authorization if necessary' to obtain any information regarding the above-mentioned information. Applicants hereby request a copy of the credit report obtained with any possible derogatory information be sent to the address of present residence, and holds Allstate Bancorp Inc and my credit reporting organization harmless in so mailing the copy requested. Any reproduction of this credit report authorization and release made by reliable means (for example, photocopy or facsimile) is considered an original.

Loan Officer working with:

Borrowers Information

Borrower Full Name* (required):

Address* (required):

City* (required):

State* (required):

Zip* (required):

Social Security Number* (required):

Date of Birth

Co-Borrower's Information

Co-Borrower Full Name:

Address:

City:

State:

Zip:

Social Security Number:

Date of Birth