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Credit Authorization Terms


I/We hereby give our consent to Synergy Mortgage Corporation, or any credit reporting bureau which it may designate, to obtain any and all information concerning our employment, checking and/or savings account, and any or all obligations with our application for a loan. This form may be reproduced or photocopied and the copy shall be as effective as the original which we have signed.

Borrower: ________________________________________

Co-Borrower: ________________________________________

Date: __________________

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CONTACT: Synergy Mortgage, Inc.,
127 Route 94 South, Suite 1, Warwick, NY 10990
Registered Mortgage Broker, New York State Department of Financial Services, All loans arranged with third-party providers
NMLSR: 32146
Phone: (845) 987-1969

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2009 Synergy Mortgage Corp. all rights reserved. Home mortgages subject to credit review and approval.