CREDIT REPORT AUTHORIZATION FORM

Authorization is hereby granted to C2 Financial Corp - Vero Beach, Florida Office, to obtain a consumer credit report through a credit reporting agency chosen by C2 Financial Corp - Vero Beach, Florida Office. I understand and agree that C2 Financial Corp - Vero Beach, Florida Office 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 C2 Financial Corp - Vero Beach, Florida Office office for use only by C2 Financial Corp - Vero Beach, Florida Office staff. This information will not be disclosed to anyone by C2 Financial Corp - Vero Beach, Florida Office without my written consent.

Furthermore, I understand that, should I choose to apply for financing through C2 Financial Corp - Vero Beach, Florida Office, 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 C2 Financial Corp - Vero Beach, Florida Office 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 C2 Financial Corp - Vero Beach, Florida Office TO OBTAIN A COPY OF YOUR CREDIT REPORT.