CREDIT REPORT AUTHORIZATION AND AUTHORIZATION TO RELEASE INFORMATION FORM

Authorization is hereby granted to Primary Residential Mortgage, Inc., to obtain a consumer credit report through a credit reporting agency chosen by Primary Residential Mortgage, Inc.. I understand and agree that Primary Residential Mortgage, Inc. 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 Primary Residential Mortgage, Inc. office for use only by Primary Residential Mortgage, Inc. staff. This information will not be disclosed to anyone by Primary Residential Mortgage, Inc. without my written consent.

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

I/We have applied for a mortgage loan from Primary Residential Mortgage, Inc. ("Lender"). In applying for a loan, I/We completed a loan application containing various information on the purpose of the loan, the amount and source of the down payment, employment and income information, and assets and liabilities. I/We certify that all the information is true and complete.

I/We authorize you to provide Primary Residential Mortgage, Inc. with any and all information and documentation that they request. Such information includes, but is not limited to, employment history, income, bank, money market, and similar account balances.