In authorization with the requirements of the Fair Credit Reporting Act, I hereby authorize the Brehmer Agency, Inc. to obtain my motor vehicle record for insurance. Underwriting Purposes, including but not limited to personal information to my employer or my prospect employer and its insurance agency, whose name and address are as follows:
Name and Address of Employer:
Anderson Landscape & Maintenance. LLC
1121 Carrington Avenue
South Milwaukee, WI 53172-1138
Name and Address of Insurance Agent:
The Brehmer Agency, Inc.
P.O Box 498
12800 W. Silver Spring Drive
Butler, WI 53007
This authorization shall continue in effect until revoked by the undersigned in writing.