Borrower Signature Authorization

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Borrower Signature Authorization
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 12 USC, 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).
Part I - General Information
1. Borrower
2. Name and address of Lender/Broker
3. Date
4. Loan Number
Part II - Borrower Authorization
I hereby authorize the Lender/Broker to verify my past and present employment earnings records, bank accounts, stock
holdings, and any other asset balances that are needed to process my mortgage loan application. I further authorize
the Lender/Broker to order a consumer credit report and verify other credit information, including past and present
mortgage and landlord references. It is understood that a copy of this form will also
serve
as
authorization.
The information the Lender/Broker obtains is only to be used in the processing of my application for a mortgage loan.
Borrower
Date
Calyx Form - bsa.hp (10/98)

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