Request And Authorization For Release Of Escrow Funds

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FOR RELEASE OF ESCROW FUNDS
REQUEST AND AUTHORIZATION FOR RELEASE OF ESCROW FUNDS
(Subdivision Name)
(Example Form)
Whereas, Pender County and
(“the Subdivider”) have entered into an
agreement to escrow funds to insure the completion of improvements in __________________
(Subdivision Name) here after referred to as the “Subdivision”; and
Whereas, a certain phase of the improvements in the Subdivision have been completed and the
parties, by their execution of this request and authorization, agree to the disbursement of escrowed
funds as follows:
(Insert improvements completed and amount to be disbursed)
Now, therefore, the parties to the Escrow Agreement for the Subdivision hereby authorize the escrow
agent to disburse the sum of __________ Dollars in accordance with the Escrow Agreement.
IN WITNESS WHEREOF, the County and the Subdivider have hereunto set their hands and seals, or if
corporate, have caused this instrument to be signed in its corporate name by its duly authorized
officers by authority of its Board of Directors, the day and year first above written.
TYPE REQUEST: Partial or Final
REQUEST FOR RELEASE OF ESCROW FUNDS:
FOR: SUBDIVIDER
Print Name
Title
Signature
Date
AUTHORIZATION FOR RELEASE OF ESCROW FUNDS:
FOR: PENDER COUNTY
Planning Director
Date

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