THIRD PARTY AUTHORIZATION FORM - LoanCare

THIRD PARTY AUTHORIZATION FORM

Loan Number: ____________________________________________________________________________________________________________________ Phone Number: ___________________________________________________________________________________________________________________ Borrower or Co- Borrower Name: __________________________________________________________________________________________________ Property Address: ________________________________________________________________________________________________________________ If Authorized Party listed on this form is the result of Power of Attorney, Administrator or Executor of an Estate, proper documentation establishing the authority must accompany this form when submitted

Authorized Party or Organization: _________________________________________________________________________________________________ Authorized Party Address: ________________________________________________________________________________________________________ Authorized Party Phone Number: __________________________________________________________________________________________________ Fax Number: ______________________________________________________________________________________________________________________

This authorization should remain effective for 30 days 60 days 90 days 120 days Life of the loan unless otherwise revoked in writing.

This authority is to be used for the following: __________________________________________________________________________________________________________________________________ I hereby authorize the above-referenced individual(s) to obtain information described above relating to my mortgage loan identified above. I understand that LoanCare will have no responsibility or liability to verify the true identity of the Authorized Party. Signature(s) Required: (Borrower or Co-Borrower)

_________________________________________________________________________________________________ Date: ___________________________

SEND THE COMPLETED FORM TO: Email: Thirdparty.auth@ Fax: 1-855-208-5631

MAILING ADDRESS: LoanCare Servicing P.O. Box 8068 Virginia Beach, VA 23450

LEARN MORE AT | 800.777.875 | TM & ? LoanCare IP Holding Company, LLC, and/or an affiliate. All rights reserved.

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