I hereby affirm, under penalty of perjury, that the foregoing declarations made and answers given are the truth without reservation. I authorize you to verify the information on this application and to receive and exchange information about me, including requesting reports from consumer reporting agencies, criminal reports, driving records, and any other relevant source. I authorize Bailey Surety Group to submit any information from this application to the Louisiana Department of Insurance or any business partner of the NIPR for licensing or information change purposes. If my application is approved, I authorize you to contact these sources for information at any time, to use information about me, including information from this application and from consumer reports.
