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INFORMATION DISCLOSURE AUTHORIZATION
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Privacy Act Notice: This
information is to be used by the agency collecting it or its
assignees in determining whether you qualify as a prospective
mortgagor under its program. It will not be disclosed outside
the agency except as required and permitted by law. You do not
have to provide this information, but if you do not your
application for approval as a prospective mortgagor or borrower
may be delayed or rejected. The information requested in this
form is authorized by Title 38, USC, Chapter 37 (if VA); by
12USC, Section 1701 et.seq. (if HUD/FHA); by 42 USC, Section
1452b (if HUD/CPD); and Title 42 USC, 1471 et.seq. or 7 USC,
1921 et.seq. (if USDA/FmHA).
I/We Hereby authorize you to release to my mortgage lender the
following information for verification purposes:
- Employment: Dates, position held, past-year and
year-to-date earnings, hours worked, probability of continued
employment, etc.
- Banking: Current balance(s), average balance(s), opening
date(s), etc.
- Mortgage/Rent: opening date, high credit, payment,
balance, payment record, etc.
- Any information deemed necessary in connection with a
consumer credit report for a real estate transaction.
The information is for the confidential use of the lender in
determining my/our creditworthiness for a mortgage loan or to
confirm information I/we have supplied. In addition I/we are
aware that the documentation supplied is subject to
re-verification after the date of loan disbursement. A
photographic or fax copy of this authorization may be deemed to
be the equivalent of the original and may be used as a duplicate
original. The original signed form is maintained in the lender's
file.
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