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Blank borrower authorization form 2026

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  1. Click ‘Get Form’ to open the blank borrower authorization form in the editor.
  2. Begin by entering the Mortgage Servicer's name and their Customer Service/Loss Mitigation phone number at the top of the form.
  3. Fill in your name(s) as the borrower(s), along with the property address and mortgage loan account number(s).
  4. In the Third Party Information section, complete all applicable fields including phone number, entity name, authorized person(s), mailing address, office address, website URL, email, tax ID#, issuing state, and state license number if required.
  5. Indicate whether you represent the borrower for a workout arrangement with a simple 'Yes' or 'No' selection.
  6. Sign and date where indicated to acknowledge compliance with regulations and confirm that all information provided is accurate.
  7. Ensure both borrowers sign and provide their printed names, last four digits of SSN, phone numbers, and emails before submitting the form to your Mortgage Servicer.

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The authorization to access employment and income history from federal or state records, including SESA records, for this transaction continues in effect for one (1) year unless limited by state law, in which case the authorization continues in effect for the maximum period, not to exceed one (1) year, allowed by law.
A borrower authorization form is a document that is completed by a borrower to authorize a lender to take certain actions on their behalf, such as obtaining a credit report or obtaining information from a third party. The form typically requires the borrower to provide basic personal information and to sign the form.
BY SIGNING THIS DOCUMENT, YOU ARE STATING THAT ALL INFORMATION YOU HAVE PROVIDED TO THIS LENDER IS ACCURATE AND VERIFIABLE. THE LENDER IS AUTHORIZED TO VERIFY OR RE-VERIFY ANY OF THE INFORMATION YOU HAVE PROVIDED IN YOUR APPLICATION AND TO OBTAIN ONE OR MORE CREDIT REPORTS.
By signing the authorization, an individual is giving consent to have their health information used or disclosed for the reasons stated on the authorization. Any use or disclosure by the covered entity or business associate must be consistent with what is stated on the form.

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