Names of Officer, Partner, Proprietor

    REFERENCES

    Reference No.1

    Reference No.2

    Reference No.3

    BANK REFERENCES:

    Bank No. 1

    Bank No. 2

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    CONFIRMATION OF CORRECTNESS AND AUTHORIZATION OF USE AND RELEASE OF
    INFORMATION

    I/We hereby authorize FairInteramerican Inc. to investigate my/our financial responsibility and credit worthiness. This is my/our ongoing authorization and consent for the herein bank reference(s) and my/our accountant, attorney or anyone else deemed necessary to release any information including without limitation a consumer credit report, requested by telephone or fax as part of FairInteramerican Inc.’s normal credit procedures. I further authorize and consent to FairInteramerican Inc. ongoing use of all such information, including without limitation a consumer credit report. I certify the above information is true and correct. Should failure to pay the invoices of FairInteramerican Inc. when due, result in collection and/or litigation, the customer shall pay to FairInteramerican Inc. all collection and/or litigation costs including attorneys’ fee.

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