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By signing this Application, the Merchant and it's owners/principals (1) certify that all information and documents submitted in connection with this are true, correct and complete and (2) authorize Broulette Capital Group, LLC, it's agents, employees, partners, and lenders to receive credit reports, background checks and any other information regarding the Merchant and it's owners and principals from third parties, to verify any information provided on the Application.

BROULETTE CAPITAL GROUP, LLC

P.O. Box 1612 Burlington, NJ, 08016

(877) 595-7264

Info@Broulette Capital Group.com

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