Appendix A.4. Authorization for Attorney

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Appendix A.4. Authorization for Attorney Powered By Docstoc
					                      AUTHORIZATION TO_____________________

Name:
Address:
DOB:
SSN:
Prior Address:

I authorize __________________ to provide ___[insert attorney’s name, attorney’s company’s
name, if appropriate, and attorney’s relationship to signatory] all of the following documents in
your possession:

Applications for Credit                             Monthly Statements
Adverse Action Notices                              Correspondence (of any kind)
Universal Data Forms (UDF)                          Automated Universal Data Forms (AUDF)
Requests for Investigations of Credit Data          Results of Investigations of Credit Data
Consumer Dispute Verification Forms (CDV)           Credit Reports
Automated Consumer Dispute Verification Forms       Payments/Payment History
Account Reviews                                     Credit Denial Determinations

for the following accounts:
         1.
         2.

I also authorize ________________ to directly discuss the above account(s) with _____[insert
attorney’s name and, if appropriate, attorney’s company’s name]___. This authorization shall
expire on ________________.


YOU MAY ACCEPT A COPY OF THIS DOCUMENT IN LIEU OF THE ORIGINAL.

________________________________________
Signature


County/City of ____________________________
State of __________________.
On this ____ day of _________________, 2008, _______________________________
personally appeared before me and acknowledged that he/she executed the foregoing instrument.

______________________________
     Notary Public
My commission expires on ________________________

				
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posted:10/2/2012
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