Accord Debt Solutions

Accord House 317 Paul Kruger Street Capital Park

Tel: 012 940 0029 Fax: 086 5033 223
P.O. Box 40188 Arcadia 0007

I ________________________ ________________________________________(Name and surname)

with identity number ___________________ _______________________

residing at _________________________________________________________ _________(address)

hereby appoint and consent to Accord Debt Solutions Marketing the following,

To request and receive from Compuscan my credit report in the same format as I would have received it

had I requested it in person.

___________________________Signature__________________________Date

Bank:
First National Bank

Account Number:
62048211180

Branch Code:
250655

Account type:
Business Cheque Account

In the name of:

Accord Debt Solutions