Borrower's Authorization Form

Borrower's Authorization Form
Please fill out the form to authorize the borrowing process.
Borrower's Information
Full Name
First NameLast Name
Date of Birth
MonthDayYear
Date
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
I, the borrower undersigned, hereby authorize [Lender's Name] to perform the following actions
Obtain and verify any information related to my account/loan.Request and receive any documents or records pertaining to my account/loan.Discuss and disclose information about my account/loan with authorized representatives of [Lender's Name].Take any necessary actions to facilitate the processing of my account/loan.
Date
MonthDayYear
Date
Signature
Clear
Should be Empty:

Borrower's Information