Release Form

EMPLOYMENT/RESIDENCY/CREDIT

RELEASE FORM

I _________________________ / ___________________________

             (Buyer)                                              (Buyer)

authorize you to release any employment, residency, and/or credit information (current and/or previous) requested by Midwest Acceptance Corp.

and/or (Dealership) ______________________________________________________

necessary to process my loan application including:  Salary Information, Dates of Employment, Position, Hours, Garnishments, Child Support Information and/or Child Support Garnishments, Mortgage and/or Rental Credit, or any other Credit Information.  I authorize the release of this information from any current and/or previous employers, creditors, landlords, mortgage holders, and child support enforcement agencies.

___________________________                 _______________

             (Buyer)                                                  (Date)

___________________________                ________________

             (Buyer)                                                 (Date)