By pressing Submit,

I/we hereby authorize PrimeWest Mortgage Investment Corporation (PWMIC) and any of its Agents to obtain personal or credit information about me/us. For the purposes of assisting PWMIC in assessing the creditworthiness of the Debtor, of the ownership or description of any Collateral, and the purpose of collection all or any portion of the indebtedness owing by the Debtor to PWMIC, the Debtor consents to the disclosure and release to PWMIC of personal information, including without limitation, motor vehicle information from Registries (or any other provincial government department having jurisdiction in that area). This consent is effective from the effective date of this agreement and shall remain in effect until all indebtedness; liabilities and other obligations of the Debtor to PWMIC are fully satisfied.

I/we hereby authorize any bank, insurance company or other lender or financial institution or agency to disclose to you any information they may have pertaining to my financial affairs and for so doing this shall be their good and sufficient authority.

I/we certify that the information in this application is true and correct. I/we consent to PWMIC obtaining from any sources such information as you may require at any time in connection with the credit hereby applied for. I/we consent to the disclosure at any time of any credit information about me/us to any credit reporting agency or to anyone with whom I/we have financial relations and if this application is for a mortgage, to any mortgage insurer or a solicitor or real estate agent involved in this transaction.