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AUTHORIZATION TO RELEASE INFORMATION

Form RD 3550-1 Form Approved(Rev. 06-06)OMB No. 0575-0172 United States Department of AgricultureRural DevelopmentRural Housing ServiceAUTHORIZATION TO RELEASE INFORMATIONTO: _____RE: _____Account or Other Identifying Number _____Name of CustomerI, and/or adults in my household, have applied for or obtained a loan or grant from the Rural Housing Service (RHS), part of the RuralDevelopment mission area of the United States Department of Agriculture. As part of the process or in considering my household forinterest credit, payment assistance, or other servicing assistance on such loan, RHS may verify INFORMATION contained in my request forassistance and in other documents required in connection with the , or another adult in my household, authorize you to provide to RHS for verification purposes the following applicable INFORMATION : Past and present employment or income records.

AUTHORIZATION TO RELEASE INFORMATION TO: _____ ... • Other consumer credit references. If the request is for a new loan or grant, I further authorize RHS to order a consumer credit report and verify other credit information. ... Disclosure of information requested is voluntary. However, failure to disclose certain items of information ...

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