Power of Attorney

To Obtain Consumer Report

To:	Experian, Equifax, TransUnion (Choose one or all)

I, _____________,hereby appoint ________________ as my agent to obtain the my consumer report. (Choose one) This authorization expires on _________, ____, 20____ OR shall remain in full force and effect until revoked by the undersigned by a written notice addressed to you and delivered to your main office.

Said agent is specifically authorized to request and obtain the my current consumer report upon request by providing identification as you require for verification of the agent’s identity.

________________________________________________________

Signature	D.O.B.	SS#	Date

___________________________

Printed Name

Authorized Agent identifying information:

________________________________________________________

Name	D.O.B.	SS#

Sworn to me before this _________ day, ____________, 20_____

Before me appeared ________________, who produced ________________as identification or who is personally known to me.

Notary Public-State of ________________	My Commission Expires:

Commission Number:________________