Mortgage Information Release
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1411 North Chestnut Street, Chaska, MN 55318
641 Marketplace Drive, Waconia, MN 55387
Phone: 952-448-5570 Fax: 952-448-5155
Phone: 952-442-3875 Fax: 952-442-1725
MORTGAGE INFORMATION RELEASE
PRIMARY MORTGAGE
SECONDARY MORTGAGE/HELOC
________________________________________
_______________________________________
MORTGAGE COMPANY #1 NAME
MORTGAGE COMPANY #2 NAME
________________________________________
_______________________________________
LOAN #
LOAN #
________________________________________
_______________________________________
PHONE # FOR CUSTOMER SERVICE
PHONE # FOR CUSTOMER SERVICE
________________________________________
_______________________________________
PROPERTY ADDRESS
PROPERTY ADDRESS
________________________________________
_______________________________________
PROPERTY CITY, STATE, ZIP
PROPERTY CITY, STATE, ZIP
SELLER #1 INFORMATION
SELLER #2 INFORMATION
________________________________________
_______________________________________
FULL NAME OF SELLER #1
FULL NAME OF SELLER #2
(First, Middle and Last)
(First, Middle and Last)
_____________-______________-____________
_____________-______________-__________
SOCIAL SECURITY NUMBER (Seller #1)
SOCIAL SECURITY NUMBER (Seller #2)
AUTHORIZATION FOR PAYOFF RELEASE:
By my signature below, I hereby authorize Scott County Abstract & Title Co., Inc., its agents or assigns to
verify my past and present accounts and payoff information that is needed to process my mortgage
closing. It is understood that a photocopy of this form will also serve as authorization. The information
that Scott County Abstract & Title Co., Inc., its agents or assigns obtains, will be used in the process of
my mortgage closing.
________________________________________
_______________________________________
SELLER #1 SIGNATURE
DATE
SELLER #2 SIGNATURE
DATE
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