AUTHORIZATION TO RELEASE INFORMATION

Lender:

Loan/Account Number#:

Property Address:

I/We hereby authorize you to release to __________________ and/or its agents and assigns any and all information that they may require about my loan/account for the above referenced property. You may reproduce this document to acquire reference from more than one source.

____________________  _________________  _________

Borrower                              Social Security#           Date

Printed Name: __________________________

____________________  _________________  _________

Co-Borrower                         Social Security#           Date

Printed Name: __________________________