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I recognize that as part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interviews with my neighbors, friends, and others with whom i may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics, and mode of living. I understand that I may have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.

The above information, to the best of my knowledge, is true and correct.

Signature of Applicant