MARINER FINANCING

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    Time at address:

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    Other Income: Alimony, child support or separate maintenance income need not be revealed if purchaser does not wish to have it considered as a basis of repaying this obligation.

    By signing below, you authorize us to make whatever credit inquires and obtain such credit as we deem necessary in connection with this credit application or in the course of review or collection of any credit extended in reliance on this application. You authorize and instruct any person to complete and furnish to us any information that we may request and agree that such information, along with this application, shall remain our property whether or not credit is extended. You authorize us to disclose any information in or relating to this application and loan account if approved.(including information received from third persons) to any applicant for, or guarantor of this credit to financial service providers we select to provide you with financial products and services we do not offer ourselves, and to any potential assignee, transferee or participant in the credit to which this application relates. You represent that all application information is true. NY Residents: We may request credit reports, other than investigative consumer reports, and, if we do, upon your request you will be informed whether a credit report was requested, and if it was, of the name and address of the consumer reporting agency that furnished the report. This notice applies to subsequent credit reports that we may request in connection with any account reviews, updates, renewals, or extensions.

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