PINNACLE MORTGAGE OF FLORIDA CORP
10556 NW 26TH ST D202
DORAL, FL 33172
Fax: 7866938913

PREMIUM CREDIT BUREAU
2701 E ATLANTIC BLVD 2ND FLOOR
POMPANO BEACH, Fl 33062

BORROWER SIGNATURE AUTHORIZATION FORM

I/We hereby authorize PINNACLE MORTGAGE OF FLORIDA CORP to verify my past and
present employment earnings records, bank accounts, stockholdings, and any other asset
balances that are needed to process my mortgage loan application. I/We further authorize
PINNACLE MORTGAGE OF FLORIDA CORP to order a consumer credit report and verify other
credit information, including past and present mortgages, and landlord references.
PINNACLE MORTGAGE OF FLORIDA CORP may also utilize the services of PREMIUM
CREDIT BUREAU to further verify my personal credit information and the information
PINNACLE MORTGAGE OF FLORIDA CORP obtains is only to be used in the processing of
my application for a mortgage loan. It is understood that a copy of this form will also serve as
authorization. This authorization expires 120 days from the date indicated below.
Privacy Act Notice: This information is to be used by the agency collecting it or its assignees in
determining whether you qualify as a prospective mortgagor under its program. It will not be
disclosed outside the agency except as required and permitted by law. You do not have to
provide this information, but if you do not your application for approval as a prospective
mortgagor or borrower may be delayed or rejected. The information requested in this form is
authorized by Title 38, USC, Chapter 37 (if VA); by 12 USC, Section 1701 et. seq. (if HUD/FHA);
by 42 USC, Section 1452b (if HUD/CPD); and Title 42 USC, 1471 et. seq., or 7 USC, 1921 et.
seq. (if USDA/FmHA).

CONFIDENTIAL INFORMATION