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655 Bridgeport AVE. Milford, CT 06460

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655 BRIDGEPORT AVE. MILFORD, CT 06460

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*The applicant certifies that the information contained herein is complete and accurate and understands that it is to be used to determine the amount and conditions of the credit to be extended. The applicant consents to the obtaining of credit and/or other information to be used at any time in connection to the account hereby applied for; and consents to and authorizes the release of any credit and financial information by any bank, trade reference, mortgage holder or landlord, and credit reporting agencies, and expressly consents to creditor obtaining a consumer credit report of the undersigned for the purposes of evaluating credit worthiness.