Third-Party Authorization Form For The Making Home Affordable

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IMPORTANT: To be considered for Hardest Hit Fund assistance, we must receive your
completed Third-Party Authorization.
Third-Party Authorization for the
Making Home Affordable and the Hardest Hit Fund Programs
Number of people in my
Bank of America, N.A.
household?"
Bank of America, N.A.
___________________________________
______________________
Mortgage Lender/Servicer Name (“Servicer”)
[Account][Loan] Number
The undersigned Borrower and Co-Borrower (if any) named below (individually and collectively,
“Borrower” or “I”), authorize the above Servicer and the following third parties and their agents
CalHFA Mortgage Assistance Corporation
CAlHFA Mortgage Assistance Corporation
_________________________________
___________________________________
[Counseling Agency]
[State HFA Entity]
_________________________________
____________________________________
[Other Third Party]
[Third-Party Contact Name and Phone Number]
(individually and collectively, “Third Party”) to obtain, share, release, discuss, and otherwise provide to
and with each other public and non-public personal information contained in or related to the mortgage
loan of the Borrower. This information may include (but is not limited to) the name, address, telephone
number, social security number, credit score, income, government monitoring information, loss mitigation
application status, account balances, program eligibility, and payment activity of the Borrower. I consent
to the disclosure of my personal information and the terms of any agreements under the Making Home
Affordable or Hardest Hit Fund Programs by Servicer or State HFA to the U.S. Department of the
Treasury or their agents in connection with their responsibilities under the Emergency Economic
Stabilization Act.
Servicer will take reasonable steps to verify the identity of a Third Party, but has no responsibility or
liability to verify the identity of such Third Party. Servicer also has no responsibility or liability for what
a Third Party does with such information.
Before signing this Third-Party Authorization, beware of foreclosure rescue scams!
It is expected that a HUD-approved housing counselor will work directly with your
lender/mortgage servicer.
Please visit to verify you are working with a
HUD-approved housing counseling agency.
Beware of anyone who asks you to pay a fee in exchange for a counseling service or
modification of a delinquent loan.
This Third-Party Authorization is valid (1) when signed by all borrowers and co-borrowers named on
the mortgage and (2) until the Servicer receives a written revocation signed by any borrower or co-
borrower.
I UNDERSTAND AND AGREE WITH THE TERMS OF THIS THIRD-PARTY AUTHORIZATION:
Borrower:
Co-Borrower:
__________________________
____________________________
Printed Name
Printed Name
__________________________
____________________________
SIGN
SIGN
Signature
Signature
HERE
HERE
__________________________
__________________________________
Date
Date
Submit Authorization Form

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