CREDIT REPORT AUTHORIZATION FORM

Authorization is hereby granted to Mid America Mortgage Southwest, Inc. Inc., hereafter referred to as (MID AMERICA), to obtain a consumer credit report through a credit reporting agency chosen by MID AMERICA. I understand and agree that MID AMERICA 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 MID AMERICA office for use only by MID AMERICA staff. This information will not be disclosed to anyone by MID AMERICA without my written consent.

Furthermore, I understand that, should I choose to apply for financing through MID AMERICA, 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 MID AMERICA 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 Mid America Mortgage Southwest, Inc. TO OBTAIN A COPY OF YOUR CREDIT REPORT.