Authorization For Use With For Profit And Non Profit Loan Assistance Consultants Form printable pdf download

Authorization

[FOR USE WITH FOR PROFIT AND NON PROFIT LOAN ASSISTANCE CONSULTANTS]

Account No.: ________________________________

The undersigned Borrower and, if applicable, Co-Borrower, hereby authorize(s) Bank of America, N.A., its affiliates,

agents and employees (collectively, “BAC”), to discuss and negotiate the terms of a workout arrangement (which may

include a loan modification, short sale, deed in lieu or other form of mortgage relief) with my (our) designated agent

(“Designated Agent”) as identified below. BAC is also authorized to share, release, discuss, and otherwise provide

public and non-public personal information contained in or related to the mortgage loan to my (our) Designated

Agent. The Designated Agent and BAC are authorized to share with each other any and all information concerning

me (us) in their possession including, but not limited to, the name, address, telephone number, social security number,

credit score, income, loss mitigation application status, account balances, program eligibility, and payment activity and

other information to the extent required to facilitate the completion of any workout arrangement, without further

authorization from me (us).

I (we) further agree and acknowledge as follows:

•

The decision to select a Designated Agent to assist in negotiating my (our) workout arrangement is voluntary;

•

I (we) can negotiate the terms of a workout arrangement directly with BAC without third party assistance; and, in

the event our Designated Agent is a “for profit” entity which charges a fee, we further acknowledge that free help is

available;

•

I (we) assume sole responsibility for any fees owed to the Designated Agent in connection with its services and

acknowledge further that BAC is not responsible for any amounts due to the Designated Agent; BAC is not

responsible for any act or omission of the Designated Agent, including anything the Designated Agent may do with

any information we provide hereunder or any failure of the Designated Agent to competently perform its services.

BAC may take reasonable steps to verify the identity of the Designated Agent, but has no responsibility or

liability to verify the identity of such Designated Agent..

This authorization will remain effective until I (we) notify BAC in writing that it is of no further force and effect.

The Designated Agent is: ______________________________________________

(insert individual name of Designated Agent (if any))

______________________________________________

(insert corporate name of Designated Agent)

EXCEPT WHERE BORROWER IS REPRESENTED BY AN ATTORNEY OR PROVIDES SPECIFIC

INSTRUCTIONS TO THE CONTRARY, THE BORROWER ACKNOWLEDGES THAT BAC MAY

FROM TIME TO TIME CONTACT THE BORROWER DIRECTLY TO CONFIRM OR PROVIDE

NOTICE OF INFORMATION RELEVANT TO THE PROCESSING AND/OR CONSUMMATION OF

THE WORKOUT ARRANGEMENT.

I UNDERSTAND AND AGREE WITH THE TERMS OF THIS THIRD-PARTY AUTHORIZATION:

Borrower

Co-Borrower

______________________________________

Printed Name

______________________________________

Signature

______________________________________

Date

Authorization For Use With For Profit And Non Profit Loan Assistance Consultants Form

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