Agency Profile.

I/we hereby authorize Transportation Insurance Experts (TIE) or its assigns to verify the accuracy of the information contained herein and to obtain business information regarding credit history from banks, creditors, credit reporting companies, and references listed on this survey. Such information, along with this survey, shall remain the property of TIE. This authorization will be valid for a period of two years from the date below or as long as the applicant has an outstanding balance with TIE. A photocopy of the authorization will be as valid as the original.

Notice: If your application is denied, you have the right to a statement of the specific reasons for denial. Contact TIE in writing within 60 days of notification; a written statement of reasons will be provided within 30 days of receiving your request.

The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age; because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law is the Federal Trade Commission · ECOA Compliance · Washington, DC 20580.