Credit Authorization Dear Patient, Please read and acknowledge the following: Credit Authorization You understand that you are applying for a loan under the Proceed Finance Program. The Provider Representative may be assisting you in the completion of an online credit application. You are authorizing Med-Den Funding LLC d/b/a Proceed Finance on behalf of Security First Bank, Lender, under the Fair Credit Reporting Act to obtain information from your personal credit profile or other information from the credit bureau and credit reporting agencies. You authorize Med-Den Funding LLC on behalf of Security First Bank, Lender, to obtain such information to confirm your identity and avoid fraudulent transactions in your name. Patriot Act IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you, when you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.