

| EXAMPLE |
| Look on your bank statements and any letters from the bank for this info to complete the Authorization. |
| Check Your Papers |
| To speed this step along fill in as much lender information as you can from your bank statement or letters. |
| Sign and print your name, social security number and date. |
| Any Co-Borrower must do the same here. Then print the address of the property to which the loan is on. |