AUTHORIZATION TO REQUEST INFORMATION
AUTHORIZATION TO RELEASE INFORMATION
I/We hereby consent to and authorize Sand Dollar Realty Group, Inc. and/or and their agents or assigns, (1) to conduct negotiations on my behalf regarding the sale of the property and the negotiation of any liens or encumbrances, and (2) to request and receive any information, including payoff figures, amounts past due, deposits, rents, account numbers and information, or otherwise from any mortgagees, lienholders, lenders, investors, mortgage insurance companies, homeowner/condominium associations, government entities, tenants or others who may have an interest in the property with the address of:
Signed:
Printed Name: Date
Signed:
Printed Name: Date
Loan #:
SS #:
Copyright © 2007-2008, Sand Dollar Realty Group, Inc. All rights reserved. Rev. 10/08.
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