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<br />Authorization to Release Information to a Third Party <br />I hereby authorize the Center for Energy and Environment –CEE-, its successors or assignees, to release limited <br />information related to my loan to the Third Party indicated below. I understand that this authorization does not make the <br />Authorized Third Party an Obligor in my account and that the Authorized Third Party is not assuming any rights to the <br />proceeds and obligations signed by me through the promissory note. I understand that this authorization does not grant the <br />Authorized Third Party any kind of access to my account online, and that CEE will not make any changes to any <br />information related to my loan, per request from the Authorized Third Party. I understand that CEE will only release <br />information related to the following topics to the Authorized Third Party: <br /> *Last Payment Received *Unpaid Principal Balance <br /> *Next Due Date *Payoff Amount <br /> *Total Amount Due *Remaining Term <br /> <br /> Authorized Third Party: <br /> Third Party's Full Name: <br /> Third Party's Date of Birth: <br /> Third Party's Last 4 of SSN: <br />I certify that I am the owner of this account and that I have the authority to allow a Third Party to receive information about <br />my loan. I understand that under the terms of this authorization, CEE is not liable in any form or manner, for the use and/or <br />dissemination of the information once it has been released to the Third Party, and I understand that I am solely responsible <br />for the misuse of such information once released to the herein Authorized Third Party. I am aware that CEE has the right <br />to withhold or deny the release of information to any Third Party that fails to verify the account through its standard <br />borrower identification procedure, and that it is my responsibility to provide my Authorized Third Party with all the details <br />needed to verify and access my account. <br /> <br /> Authorizing Borrower: <br /> Name: Loan Number: 2150 <br /> Date of Birth: Last 4 of SSN: <br /> <br /> <br /> Borrower's Signature: Date: <br />Center for Energy and Environment | 212 Third Avenue North, Suite 560 | Minneapolis, MN 55401 <br />Ph.: 1-855-296-5626 | Fax: 612-455-7805 | www.mncee.org | https://mncee.loanpro.software | loanservicing@mncee.org <br />LS004-073018