BUSINESS INFORMATION

    OWNER/PERSONAL INFORMATION

    Owner/Personal Information

    FINANCIAL INFORMATION


    AUTHORIZATIONS: By signing below, each of the above listed business and business owner/officer (individually and collectively, “you”) authorize MSC LEGACY CORP and each of its representatives, successors, assigns and designees (“Recipients”) that may be involved with or acquire Personal loans having repayment features or purchases of future receivables including loans, transactions, including without limitation the application therefor (collectively, “Transactions”) to obtain consumer or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize MSC Legacy to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to MSC Legacy and to each of the Recipients, on its own behalf. CONSENT TO TELEPHONE CALLS: You expressly consent to receiving marketing and other call and messages, to a landline, wireless or similar devices, including auto-dialled and prerecorded message calls, and SMS messages (including text messages) from Recipients, at telephone numbers that you have provided. Message and data rates may apply. Your consent to receive marketing calls is not required for your application; if you do not consent, do not provide a phone number. CONSENT TO ELECTRONIC DISCLOSURES: You expressly consent to transactions and disclosures with Recipients online and electronically. Disclosure will be provided to you either on the screen, on the Recipient’s website or via electronic mail to the email address you provided. WITHDRAWING CONSENT: You may withdraw your consent for telephone calls or electronic disclosure by calling the Companies’ Customer Service team at 954-848-2808 or emailing underwriting@msclegacycorp.com

    SIGNATURE

    I accept that all details above are correct and accurate to the best of my knowledge.*