Authorization To Release Information

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AUTHORIZATION TO RELEASE
INFORMATION
Lender ______________________________________
Owner(s) ____________________________________
____________________________________
Loan # ______________________________________
Property _____________________________________
Date: ________________________________________
I/We hereby authorize the release of information to ____________________________ or its
agents and assigns any and all information that they may require about my loan, mortgage/trust
deed, assumption loan package, payoff loan statement, insurance, tax reference information
concerning the above referenced property.
You may reproduce this document to acquire reference from more than one source.
Furthermore, “agents” shall include all real estate brokers and their salespersons or assistants,
title or escrow companies and their employees, attorneys and their employees and other assigns.
Thank You,
Name__________________________ SSN_______________ Date________________
Phone #_________________
Name__________________________ SSN_______________ Date________________
Phone #_________________

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