AUTHORIZATION TO RELEASE INFORMATION - DOC by 23K0Jb

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									                         AUTHORIZATION TO RELEASE INFORMATION


                             DATE: _______________________________
To Whom It Concerns:

The undersigned hereby authorizes the release of information to FIRST TITLE OF SOUTWEST FLORIDA, INC.
regarding the

  SALE        OR    REFINANCE        (circle one)   of the referenced property, including payoff information,

homeowner’s association information, sewer assessment information, etc.


    PROPERTY ADDRESS: _______________________________________________________________
   ________________________________________________________________________________________


  CURRENT MORTGAGES / LIENS ON PROPERTY:

       (1) LENDER: ________________________________________________________________________

             PHONE: ____________________________ LOAN NUMBER: ____________________________


       (2) LENDER: ________________________________________________________________________

             PHONE: ____________________________ LOAN NUMBER: ____________________________


       (3) LENDER: ________________________________________________________________________

             PHONE: ____________________________ LOAN NUMBER: ____________________________


Sincerely,


BORROWER / SELLER:
(Printed)_________________________________________(Signature)______________________________________


Social Security #: _____________________________Phone: (H)____________________(W)___________________


BORROWER / SELLER:
(Printed)_________________________________________(Signature)______________________________________


Social Security #: _____________________________Phone: (H)____________________(W)___________________

								
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