Agenda - 01-28-2014 - 2 - Laserfiche WebLink

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Orange County NC Radio Communication Tower and System Infrastructure Upgrade RF Coverage and Sites/Towers Personal Credit Release By signing this application, I authorize Crown Castle or its agency to investigate my personal credit and financial records. As part of such investigation, I authorize Crown Castle to request and obtain consumer credit reports on me in connection with the opening, monitoring, renewal and extension of this and other accounts with Crown Castle and the marketing of other products and services to me and my business by Crown Castle. I further authorize Crown Castle to share the information received from my consumer credit report with Crown Castle's parent, subsidiaries and affiliates (and others if applicable). If I request, you will tell me whether my consumer credit report was requested and if so the name and address of the consumer credit agency that furnished the report. Any misrepresentation in this application will be considered evidence of a fraud, since this information is the basis of the granting of credit. As an inducement to grant credit, the undersigned warrants that the information submitted is true and correct. You are authorized to investigate the credit references listed. Print Name Title Social Security # Signature Date Print Name Title Social Security # Signature Date Personal Guarantee By signing this Application, I acknowledge that I have personally guaranteed the debts and obligations of my business and agree that I am personally obligated to perform all of the terms of and make all payments to Crown Castle required by, the agreement of which this Application is a part. Print Name Print Name Signature Date Signature Date Personal Credit Release form should be sent to: Alicia Hildebrand Credito,crowncastle.com Phone: 724 -416 -2208 Fax: 724416 -4208 August 30, 2013 Page 51 of 51 u� 52