COMPANY INFORMATION

BUSINESS OWNER

CO-­APPLICANT

LOAN REQUEST

CERTIFICATION AND AGREEMENT

I hereby certify that all information contained in this application is correct. I hereby authorize Commercial Credit Access, LLC, its subsidiaries, its designated agents or assigns to conduct any investigation it sees fit as to the creditworthiness of the company and all principals individually by utilizing any credit reporting agency as and when needed, and to file the appropriate financing statements pursuant to the Uniform Commercial Code or applicable legislation, describing the collateral as all assets of the Debtor or similar language. I understand that the contents of said investigation and any ensuing reports will be, and remain, confidential. Without limiting the generality of the foregoing, I hereby authorize Commercial Credit Access, LLC, its subsidiaries, agents and assigns to use, collect and disclose the foregoing information for the purposes stated herein. Commercial Credit Access, LLC will take reasonable precaution to safeguard such information to prevent it from theft, loss, or unauthorized disclosure. Commercial Credit Access, LLC will keep such information for as long as necessary to provide the financing contemplated herein. Sign Individually, with Title: Please have all principals sign below; attach additional sheets if necessary.