Permission To Provide Information

To:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
 

RE:
___________________________________________________________________
___________________________________________________________________

You are authorized to give WALL STREET BROKERS, INC., any and all
information and documentation requested at any time.

A copy or facsimile of this signed document is to be considered an original.
 

_____________________________________________________________
Name (typed or printed)

___________________________________________________________________
Signature

cc:
Wall Street Brokers, Inc.
500 Wall Street, Suite 405
Seattle WA 98121-1577
Phone: 206.448.1160
Fax: 206.448.8476
e-mail: info@divorceliens.com
URL: www.divorceliens.com