Registration form page

[si-contact-form form=’5′]


LETTER OF AUTHORIZATION

 

Date:

 

Property and Mortgage / Lien Holder Information

 

To:  1st Mortgage / Lien Holder: _______________________________

Re:  1st Mortgage or Loan / Account Number: ____________________

 

To:  2nd Mortgage / Lien Holder: _______________________________

Re:  2nd Mortgage or Loan / Account Number: ____________________

 

To:  Other Mortgage / Lien Holder: _______________________________

Re:  Other Mortgage or Loan / Account Number: ____________________

 

Property u0026amp; Borrower / Homeowner Information

 

Property Address: ________________________ City: _______________    State:___Zip_______

 

Property Owner(s) Name: __________________________ u0026amp; __________________________

 

Primary Borrower Last 4 of  SSN: ______________ Co-Borrower Last 4 of SSN________________

 

 

To Whom It May Concern:

 

I, __________________________ u0026amp;  ___________________________

Borrower                                                Co-Borrower

 

herewith give the above referenced mortgage holder / lender, attorney, servicer, and/or insurer of the mortgage loan or credit card debt referenced above permission to speak with and disclose financial records pertaining to the loan or debt to John Newman, Liz Bell, and Nicole Newman of Keller Williams Realty and or each of his respective assigns, associates, employees or agents.  A facsimile copy of this document may serve with all of the rights and legalities as an original.  Accordingly, I agree to indemnify and hold harmless, John Newman, Liz Bell and Nicole Newman of Keller Williams Realty and or each of his respective assigns, associates, employees or agents from any liability for actions taken by the lender or as a result of this contemplated short sale transaction.

 

 

_________________________________ Signature      ________________ Date

 

_________________________________ Signature      ________________ Date