CREDIT BUREAU SERVICES, INC.
Date:
TO:
Credit Bureau Services, Inc.
Fax: 954-567-1441
FROM:
_______________________________________________
(PRINT
your name here)
I am an independent loan originator approved by and through
___________________________________________________________________________
Name of Mortgage Company
I personally guarantee payment of all fees and charges owed Credit Bureau Services, Inc. and you have my permission to pull my credit report.
Name: _________________________________________________________
Street: _________________________________________________________
City, State & Zip : ________________________________________________
Home Telephone: ________________________________________________
Office Telephone: ________________________________________________
Cell Phone: _____________________________________________________
Fax: __________________________________________________________
Social Security No: ______________________________________________
Email: _________________________________________________________
Signature
and Date
Please fax this form to
954-567-1441 along with a copy of your driver's license or other acceptable form
of photo ID. If you do not provide an ID, your application will not be
processed..
If your credit is okay, we will bill you monthly for your credit report
charges. If your credit is not
okay, you will have to pay by credit card.
Thank you! We
appreciate your business!
3503 N. Dixie Hwy, Oakland Park, FL 33334
954-561-1400
FAX: 954-567-1441
www.credit1400.com
Credit
Bureau Services, Inc.
3503 N Dixie Hwy., Oakland Park, FL 33334
954-561-1400 FAX: 954-567-1441
Credit Card Authorization:
LOAN
OFFICER NAME: __________________________________
CREDIT CARD NO. _________________________
EXP. DATE :____________ CVS CODE:____________
CARDHOLDER INFORMATION – PLEASE PRINT
NAME:___________________________________
PHONE NO________________Zip Code_________
SIGNATURE:_______________________________
EMAIL: ___________________________________