LETTER OF AUTHORIZATION

To whom it may concern:

This is to allow ES Print Media Inc., through its authorized representative, to verify all
Pertinent information such as:

Length of Business Relation: _____________________________

Types of account: _____________________________
History of Return Cheque:_______________________________ This part should be fill out by the
Average Daily Balance (Digit): ___________________________ BANK representative
Credit Facilities: _____________________________
Account Status: _____________________________
with my bank (s) / financial references relative to the evaluation of my credit application.

Name of Bank:
Account Name: This part should be
Account No: fill out by the CLIENT
Type of Account:

I further understand that any information gathered shall be kept fully confidential and
shall be used for credit evaluation purposes only.

Thank you!

Sincerely,

Signature of CLIENT
_____________________________
(Signature)

Name:
Date: CLIENT Detail's
Mobile:

(Do not write below this line) Signature of BANK Rep.

Authorized ESPMi Representative: Bank Representative:_________

__________________________ _____________________________
Print Name over Signature Print Name over Signature / Date