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<br />THIS FORM MUST BE SIGNED AND RETURNED WITH THE APPLICATION <br /> <br /> <br />AUTHORIZATION TO RELEASE INFORMATION <br /> <br /> <br />I have applied for a loan through the Elk River HRA. As part of the application process, city staff may verify <br />information contained in my/our loan or grant application and in other documents required in connection with <br />the loan. This verification process can be conducted either prior to closing or subsequent to closing, and may be <br />performed either by city staff or by independent third parties, as a part of the origination, processing, <br />underwriting, closing or quality control programs. <br /> <br />I authorize you to provide to the City of Elk River and to any investor to whom the city may sell my loan, to <br />any servicer or any funder of the program for which I have applied, any and all information and documentation <br />that they request. <br /> <br />Such information includes, but is not limited to employment history, income; bank, money market and other <br />financial account balances; credit history; copies of income tax returns and property information. <br /> <br />A copy of this authorization may be accepted as an original. Your prompt reply is appreciated. <br /> <br />Thank you. <br /> <br /> <br /> <br />___________________________________ XXX-XX-_______ _____________ <br />Print Name Social Security # (last 4 digits) Date <br /> <br />___________________________________ <br />Signature <br /> <br /> <br /> <br /> <br />NOTE: Use a separate form for each individual who is an applicant, guarantor or other individual whose <br />Only one person signs each form <br />information is considered in the application. . <br /> <br /> <br />181302v1 <br />15 <br />