CREDIT REPORT AUTHORIZATION FORM


Access Mortage Corporation

425 Hollywood Blvd., P.O. Box 189, Mary Esther, FL 32569

(904)243-1994 * Fax (904)243-1964



Authorization to Release Information

Gentlemen:


I have made an application to Access Mortage Corporation to obtain a loan to purchase/build a home. As part of this process, I have named you as a reference and ask that you release any and all information concerning my account upon their request. Such information includes, but is not limited to, employment history and income, bank, money market, and similar account balances, credit history, and copies of income tax returns.

In the event the loan is sold to an investor, I authorize the release of the information referenced above upon request.

Furthermore, from time to time, Access Mortage Corporation or its assignee may elect to perform reverifications as part of a quality control review audit. These audits may be performed internally or by an independent third party quality control review agent.

Photostatic copies of this letter may be made to facilitate multiple inquiries. In the event you recieve such a copy, it should be treated as an original and the requested information released.

Thank you for your cooperation in this matter.

BorrowerDate
Co-borrowerDate

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