Credit Information Authorization

Capital Sources, Inc.

704 N. E. Langsford Rd.

Lee’s Summit, MO. 64063

816-246-6740 Fax 246-6736

email: danpack@capitalsourcesinc.com

Authorization for Obtaining Credit Information

By signing below, each undersigned individual(s) as principal of and/or guarantor for the applicant,(_______________________________________) authorizes Capital Sources, Inc., its designee, assigns or potential assigns, to review his/her personal credit profile provided by national credit bureaus in considering the application for and for the purpose of the update, renewal, or extension of credit to the applicant or the collection of any resultant accounts. Also in the event your application for credit is denied you have the right to a statement of specific reason for such denial within 30 days after you send a written request to C$I at the address shown above said request must be received within 60 days after credit is denied. A fax or photocopy of this authorization shall be valid as the original.

_______________________ _______________ ______________________ _______

Signature Social Security # Print Name Date

_______________________ _______________ ______________________ _______

Signature Social Security # Print Name Date

Capital Sources, Inc.

Privacy Policy

We collect nonpublic personal information about you from the following sources:

Information we receive from you on applications, federal tax returns, worksheets, and other documents we use in preparing your business plan, lease contract, business loan, or other forms;
Information about your transactions with us or others; and
Information we receive from a consumer reporting agency.

We do not disclose any nonpublic personal information about you to anyone, except as permitted by law.

If you decide to close your account(s) or become an inactive customer, we will adhere to the privacy policies and practices as described in this notice.

We restrict access to your personal and account information to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal standards to guard your nonpublic personal information.

Your confidence in us is important and we want you to know that your personal and account information is safe. If you have any questions, or concerns, please contact us.