Information Authorization Disclosure

I/We hereby authorize you to release to Commonwealth Title & Mortgage Services, INC their successors and/or assigns the following information for the purpose of verification.

• Mortgage Loan Payoff Statements/Information
• Judgments
• Federal/State Tax Liens

This information is for the confidential use in compiling a mortgage loan credit file for a home loan.

A photographic or carbon copy if the authorization (being a valid copy of the signature(s) of the undersigned) may be deemed to be the equivalent of the original and may be used as a duplicate original.

Your prompt reply will help this real estate transaction.

Thank you.
Name*
First Last
Name
First Last
Signature*
Signature
Date*
MM slash DD slash YYYY
Date
MM slash DD slash YYYY
Social Security Number*
Social Security Number