CREDIT REPORT AUTHORIZATION FORM

Authorization is hereby granted to Western Capital Mortgage DBA First Alliance Mortgage, to obtain a consumer credit report through a credit reporting agency chosen by our company. I understand and agree that Western Capital Mortgage 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 Western Capital Mortgage office for use only by Western Capital Mortgage staff. This information will not be disclosed to anyone by Western Capital Mortgage without my written consent.

Furthermore, I understand that, should I choose to apply for financing through Western Capital Mortgage, 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 Western Capital Mortgage 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 Western Capital Mortgage TO OBTAIN A COPY OF YOUR CREDIT REPORT.