GENERAL AUTHORIZATION FORM
Print this page
and fill it out completely. Use a typewriter, or print clearly. Then fax or mail it
to us at the address at the bottom of this page.
________________________________________________
APPLICANT NAME
________________________________________________
APPLICANT NAME
________________________________________________
APPLICANT NAME
________________________________________________
APPLICANT NAME
I hereby authorize the
lender ___________________________ and/or their assigns (if any) to verify my past and
present employment earnings records (including information contained in income tax returns
that have been filed with the IRS), employers (past and present), bank accounts, stock
holdings, and any other asset balances that are needed to process my mortgage loan
application, or to review it for quality control purposes. I authorize the lender to quote
verbal/written information about the status of my loan to all real estate brokers/builders
that are a party to the transaction. I further authorize the lender to order a consumer
credit report and verify other credit information, including past and present mortgage and
landlord references. It is understood that a photocopy or facsimile copy of this from will
also serve as authorization.
The information that the lender
and/or mortgage insurer (if any) obtains is only to be used in the processing of my
application for a mortgage loan, or in the quality control review of my loan.
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Applicant Signature |
Social Security No. |
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Applicant Signature |
Social Security No. |
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Applicant Signature |
Social Security No. |
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Applicant Signature |
Social Security No. |
Notice to Applicant:
This is a notice to you as required by the
Right to Financial Privacy Act of 1973 that HUD/FHA has a right of access to financial
record held by financial Institutions in connection with the consideration or
administration of assistance to you. Financial record: involving your transaction will be
available to HUD/FHA without further notice of authorization but will not be disclosed or
released by this institution to another Government Agency or Department without your
consent except as required or permitted by law.
You do not have to give us 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, U.S.C., Chapter 37 (if VA); by 12 U.S.C., Section 1701 et seq. (if HUD/FHA);
BY 42 U.S.C., Section i452b (if HUD/CPD); and Title 42 U.S.C., et seq., or 7
U.S.C., 1921
et seq. (if USDA, FMHA).
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