Application Fee - Credit Release Form

Application Fee - Credit Release Form

*Application Fee is $75.00 covers 2 applicants and 1 business
Full Name

First NameLast Name
Personal Phone

Area CodePhone Number
Business/Alternate Phone

Area CodePhone Number
Birthdate

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Social Security #
Business Name Tax ID if Available

Business NameTax ID: If availalbe
E-mail
Address Personal

Street Address

Street Address Line 2

CityState

Zip Code
Have you had your credit file frozen recently?
Signature Permission

I give permission to VEDIC to do credit checks on myself and/or the business I own for the purpose of securing a business loan with VEDIC. $75 Application Fee will cover two reports and business report. If additional applicants are needed additional fees will be charged. Reports will be pulled after receiving you *$75 Application Fee which can be mailed to VEDIC Box 1225 Valdese, NC 28690 or you will be billed.
Should be Empty: