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Get Wells Fargo Authorization to Inquire Form

Limited as stated below Reason needed third party personal information and Start Date End Date Borrower s signature Third party information Name Address Third party signature Disclosure statement This authorization allows limited information access to your account for the third party listed. This authorization does not provide third parties with authorization to advance any available credit or make financial decisions regarding this account. The third parties may be asked to provide personal information to verify the identity if a call is made to request specific information about your account. Wells Fargo may refuse to disclose any information to a third party who cannot verify his or her secure information. Return completed form to Wells Fargo Attn Home Equity Correspondence MAC X2302-04E P. Authorization to Inquire Account holder Date Account number New authorization Cancel existing authorization Customer name Last 4 digits of SSN Phone number Mailing address City State Zip I hereby authorize included below to access information regarding my account. Limited as stated below Reason needed third party personal information and Start Date End Date Borrower s signature Third party information Name Address Third party signature Disclosure statement This authorization allows limited information access to your account for the third party listed* This authorization does not provide third parties with authorization to advance any available credit or make financial decisions regarding this account. The third parties may be asked to provide personal information to verify the identity if a call is made to request specific information about your account. Wells Fargo may refuse to disclose any information to a third party who cannot verify his or her secure information* Return completed form to Wells Fargo Attn Home Equity Correspondence MAC X2302-04E P. O. Box 10335 Des Moines IA 50306 - 0335 Fax 866-328-0418 2013 Wells Fargo Bank N*A. All rights reserved* NMLSR ID 399801. Authorization to Inquire Account holder Date Account number New authorization Cancel existing authorization Customer name Last 4 digits of SSN Phone number Mailing address City State Zip I hereby authorize included below to access information regarding my account. Limited as stated below Reason needed third party personal information and Start Date End Date Borrower s signature Third party information Name Address Third party signature Disclosure statement This authorization allows limited information access to your account for the third party listed* This authorization does not provide third parties with authorization to advance any available credit or make financial decisions regarding this account. Limited as stated below Reason needed third party personal information and Start Date End Date Borrower s signature Third party information Name Address Third party signature Disclosure statement This authorization allows limited information access to your account for the third party listed* This authorization does not provide third parties with authorization to advance any available credit or make financial decisions regarding this account. The third parties may be asked to provide personal information to verify the identity if a call is made to request specific information about your account. .

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