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Credit Bureau Check - Debit Authorization Form
Credit Bureau Check - Debit Authorization Form
I/We consent to the Bank conducting credit checks on me/us from at least 2 credit bureaus as a
condition for processing my/our facility application, in line with regulatory requirements.
I/We hereby authorize the Bank to debit my/our account number ……………………………… for the
sum of =N= ………………… Retail Search (=N=3,500) Corporate/Business Search (=N=3,500) upon
receipt of negative credit report, from 2 credit bureaus in respect of my/our facility application.
Authorized by
…………………………… …………………………………..
Name/Signature/Date Name/Signature/Date
The sum of =N= ……………. for credit bureau checks has been debited to customer’s
account/collected in cash from customer, and credited to the Credit Bureau Charges SRA
0002249417.
Branch:
Teller Name/Signature/Date:
Teller Stamp:
ASO Name/Signature/Date: