I hereby declare I am applying for a sales contract with US Credit Sales Inc. and/or one of it’s partners, affiliates, or brokers/dealers under the provision of Section 552a(b) Public Law 93-579, commonly known as the Privacy Act, Dept. of Defense 5400.11 enc 5 Par3 - 2 apr 340 - 21 Dept. of the Army, 27 August 1975 Section C, Par 24 AFR 12-35, Dept. of the Air Force Par 7a(1), SECNABINST 5211.5 Dept. of the Navy 14 August 1975.

I understand that my application may be submitted to one or more lenders, partners, affiliates, or brokers/dealers to obtain suitable financing for said contract. I further understand that the Lender will not contact my Commanding Officer in connection with this debt unless I specifically give the Lender prior consent to make such contact. With full knowledge and understanding of this right, I hereby consent to contacting my Commanding Officer/Personnel Officer and/or Custodian of my official records to obtain my current military and /or civilian address even though I may be discharged and/or retired from military service. I also consent to you contacting my Commanding Officer in connection with the collection of the debt made hereby at any time when it is in default and until such time as the debt has been paid in full.