CREDIT REPORT AUTHORIZATION FORM

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

Furthermore, I understand that, should I choose to apply for financing through City Island Associates, 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 City Island Associates, 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 City Island Associates, inc. TO OBTAIN A COPY OF YOUR CREDIT REPORT.