To:   The Manager, .........................................................................................Bank/Building Society

Address: ................................................................................................................................................

.................................................................................................................................................................

I/We .........................................................................................................................................................

of .............................................................................................................................................................

.................................................................................................................................................................

hereby authorise the Bank/Building Society to provide a status enquiry reference to:

Antony Richards Property Services

Jupiter House

11 Market Place

Penzance

Cornwall

TR18 2JB

following our application for the tenancy of a property at a rent of £......................p.c.m.

Any charges levied by the Bank for this service can be deducted from my/our account.

Bank Sort Code ................................................ Account No ................................................................

Name of Account Holder(s) ...................................................................................................................

Signed ........................................................................................ Dated ................................................