Free Third Party Authorization Form Template
Third Party Authorization Form
Please complete this Third Party Authorization Form Template to officially grant permission for a third party to act on your behalf.
Mortgage Lender/Servicer Name (Servicer)
Account Number
Loan Number
Authorized Third Party Contact Information
Please fill in the information below.
Name
example@example.com
Name of the Entity, Agency, Firm,(If Applicable)
Address of Entity, Agency, Firm (If Applicable)
The undersigned, on behalf of the Third Party, Acknowledges the accuracy and compatibility of the above information. A false statement or omission of truth may result in civil/criminal punishment.
I declare that I understand and agree with the terms of this third party authorization
Borrower Signature
Date:
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