How to fill out this form.

Write the third party's full name and list their relationship to you and give a phone number for the third party.
Check each type of authorization you would like to give to the third party (you may initial multiple authorizations).
Ensure each homeowner signs and dates the completed form for the authorization to be valid.
Wells Fargo reserves the right to terminate working with any authorized third party at its discretion.
Upload, fax, or mail the form to us.

See an example form

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Third Party Authorization

To be completed by: Homeowner(s)

Fill in all required field(s) below*

The following fields need to be corrected:*

Loan number:

Homeowner name:

Co-Homeowner name:

Property address:

I/We (#000000) authorize the following third party:

Third party name *

Relationship to Borrower *

Third party phone number *

Please initial the type(s) of authorization you would like the above-mentioned third party to have regarding your claim.

Request inspections
Request claim status information
Send draws directly to third party address
Be the main contact for the property repair process
Other __________________________________________________________________________

Please sign below:

Signature

Date

Co-Borrower's Signature

Date

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