When you need to authorize someone else to act on your behalf, you'll need to fill out a third party authorization form. This document allows the individual listed as the authorized representative to make decisions or take action on your behalf. There are a few things to keep in mind when completing this form, so be sure to read through the instructions carefully. The process can seem a little daunting at first, but with a little preparation, it's easy enough to do. So let's take a closer look at what's involved in filling out a third party authorization form. Third Party Authorization forms allow for individuals who are not legally able or cannot represent themselves for medical decision making etc.
The table includes information about the third party authorization form. Before you decide to fill out the form, it can be worth checking a little more about it.
| Question | Answer |
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| Form Name | Third Party Authorization Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | third party auth myloancare com, thirdparty auth myloancare com, thirdpartyauth myloancare com, party authorization form |
THIRD PARTY AUTHORIZATION FORM
Homeowner Information
Borrower Name |
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Co‐Borrower Name |
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Mailing Address |
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Property Address (if different than mailing address) |
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Daytime: |
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Evening: |
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Cell: |
E‐mail Address: |
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Phone Numbers/ |
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Contact Information |
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Mortgage Information |
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Name of Mortgage Company (i.e., Mortgage Servicer) |
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Loan Number |
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Mortgage Company Contact Name |
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Contact Phone |
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Contact E‐mail Address |
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Lender Name (if Different Than Mortgage Company) |
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Loan Number |
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Lender Contact Name |
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Contact Phone |
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Contact E‐mail Address |
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Housing Counselor Agency |
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Agency’s File Number |
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Housing Counselor Name |
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Contact Phone |
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Contact E‐mail Address |
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Authorized Third Party |
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Contact Phone |
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Contact E‐mail Address |
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Loan Type |
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Conventional |
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FHA |
VA |
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Foreclosure Sale Date (if applicable) |
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The undersigned Borrower and, if applicable, Co‐Borrower, is/are currently working with the Housing Counselor named above and hereby authorize the Housing Counselor and its employees to speak with and discuss my mortgage loan on my behalf with the Lender and the Mortgage Loan Servicer named above, as well as with the owner of the mortgage loan (such as Fannie Mae and Freddie Mac), with the Lender, the Mortgage Loan Servicer and the owner of the mortgage loan collectively referred to as “Mortgagee,” and also authorize each of the entities constituting the Mortgagee to speak with and discuss my mortgage loan on my behalf with the Housing Counselor and any Authorized Third Party named above. The Housing Counselor and each of the entities constituting the Mortgagee are each authorized to share with the other any and all information concerning me/us in their possession including, but not limited to, financial information, without further authorization from me/us.
The Housing Counselor and its employees are authorized to furnish copies of this Authorization to any of the entities constituting the Mortgagee and such entities may rely on this Authorization.
Borrower’s Signature |
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Co‐Borrower’s Signature |
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4/2013