CREDIT REPORT AUTHORIZATION FORM

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

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