"Authorization to Release Information
Authorization dated this day of , 20 . Borrower(s):
Loan / Account # Property Address
To:
and / or their agents / assigns.
I / We, the undersigned, hereby authorize you to release any information regarding the above referenced loan / account to _                and / or their agents / assigns. This form may be duplicated in blank and or sent via facsimile transmission. This authorization is a continuous authorization for said persons to receive information about this loan / account, including duplicates of any notices sent to me / us regarding this account.
Borrower                         Borrower
SSN #                           SSN #
DOB:                           DOB:"