Credit Check Authorization

*Company Name
*Registration Number

*Company Address

*Company Telephone number

*Street Number & Name	*Suburb
*City	*Code

I, , E-mail , authorize Race Screen Technology to obtain a Background Check and / or Consumer Credit Report on me. This authorization is valid for purposes of verifying information given pursuant to employment, leasing, rental, business negotiations, or any other lawful purpose covered under the National Credit Act.. This authorization shall be valid in original or copy form.

I hereby confirm that I have read and agreed to the Dealership terms and conditions

I hereby confirm that I have read and agreed to the Credit Report Authorization Conditions

Optional Notes

Credit Check Authorization

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