Finance of America Mortgage LLC

Transcription

1 Finance of America Mortgage LLC

2 Right of Financial Privacy Act of 1978 Notice - The Department of Housing and Urban Development (HUD) and the Department of Veterans Affairs (VA) have the right to access financial information held by a financial institution in determining whether to qualify a prospective applicant under their respective loan programs. If you are applying for HUD or VA loan, your financial records will be made available to the requesting government agency without further notice to or authorization from you; such financial information will not be disclosed or released outside the requesting agency except as required or permitted by law. Prior to the time that your financial records are disclosed, you may revoke this authorization at any time; however, your refusal to provide the information may cause your application to be delayed or rejected. If you believe that your financial records have been disclosed improperly, you may have legal rights under the Right to Financial Privacy Act of 1978 (12 USC 3400 et seq. ). Borrower's Signature Date SOCIAL SECURITY NUMBER Co-Borrower's Signature Date SOCIAL SECURITY NUMBER BORROWERS CERTIFICATION AND AUTHORIZATION BorrowersCertAuth Page 2 or 2

3 CERTIFICATION OF VERBAL AUTHORIZATION FOR RELEASE OF INFORMATION This section is to be filled out by the Mortgage Advisor or Processor I,, hereby certify that on 20, I spoke to and ( the "borrower(s)"), he/she/they have verbally authorized FINANCE OF AMERICA MORTGAGE LLC / NMLS # 1071 to obtain copies of his/her/their credit report(s). I agree that this consent is authorized and that I shall bear the full burden of proof in the event that this release is contested. Mortgage Advisor or Processor By: By: I / We certify that the above information is true and correct. I / We did give Mortgage Advisor or Transaction Coordinator with FINANCE OF AMERICA MORTGAGE LLC / NMLS # 1071 permission to pull my / our credit report(s) Finance of America Mortgage LLC, NMLS# 1071 (NMLS Consumer Access) CertVerbAuthRel

4 Form Approved Social Security Administration OMB No Authorization for the Social Security Administration (SSA) to Release Social Security Number (SSN) Verification Printed Name: Date of Birth: Test \ Test 02/08/1980 I want this information released because I am conducting the following business transaction: Social Security Number: Seeking a mortgage from RateWise Mortgage Reason (s) for using CBSV: (Please select all that apply) Mortgage Service Background Check Credit Check Banking Service License Requirement Other with the following company ("the Company"): Company Name: Company Address: RateWise Mortgage 8670 West Cheyenne Ave Suite 120, Las Vegas, NV I authorize the Social Security Administration to verify my name and SSN to the Company and/or the Company s Agent, if applicable, for the purpose I identified. The name and address of the Company s Agent is: Data Verify (866) Parkway Center 875 Greentree Road Pittsburgh, PA I am the individual to whom the Social Security number was issued or the parent or legal guardian of a minor, or the legal guardian of a legally incompetent adult. I declare and affirm under the penalty of perjury that the information contained herein is true and correct. I acknowledge that if I make any representation that I know is false to obtain information from Social Security records, I could be found guilty of a misdemeanor and fined up to $5,000. This consent is valid only for 90 days from the date signed, unless indicated otherwise by the individual named above. If you wish to change this timeframe, fill in the following: This consent is valid for days from the date signed. (Please initial.) Signature Date Signed Relationship (if not the individual to whom the SSN was issued): Contact information of individual signing authorization: Address City/State/Zip test Las Vegas, NV Phone Number Form SSA-89 ( )

5 Privacy Act Statement SSA is authorized to collect the information on this form under Sections 205 and 1106 of the Social Security Act and the Privacy Act of 1974 (5 U.S.C. 552a). We need this information to provide the verification of your name and SSN to the Company and/or the Company's Agent named on this form. Giving us this information is voluntary. However, we cannot honor your request to release this information without your consent. SSA may also use the information we collect on this form for such purposes authorized by law, including to ensure the Company and/or Company's Agent's appropriate use of the SSN verification service. Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. 3507, as amended by section 2 of the Paperwork Reduction Act of You do not need to answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take about 3 minutes to complete the form. You may send comments on our time estimate above to: SSA, 6401 Security Blvd., Baltimore, MD Send to this address only comments relating to our time estimate, not the completed form. TEAR OFF NOTICE TO NUMBER HOLDER The Company and/or its Agent have entered into an agreement with SSA that, among other things, includes restrictions on the further use and disclosure of SSA's verification of your SSN. To view a copy of the entire model agreement, visit Form SSA-89 ( )