CREDIT REPORT AUTHORIZATION FORM

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

Furthermore, I understand that, should I choose to apply for financing through SouthPoint Financial DBA Geneva Financial, 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 SouthPoint Financial DBA Geneva Financial 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 SouthPoint Financial DBA Geneva Financial TO OBTAIN A COPY OF YOUR CREDIT REPORT.