SSA-89 (04-2017) Page 1 of 2 Social Security ...

Form SSA-89 (04- 2017 ) Page 1 of 2. Social Security administration OMB Authorization for the Social Security administration (SSA). To Release Social Security Number (SSN) Verification Printed Name: Date of Birth: Social Security Number: I want this information released because I am conducting the following business transaction: Seeking a mortgage from the company. Reason (s) for using CBSV: (Please select all that apply). Mortgage Service Banking Service Background Check License Requirement Credit Check Other with the following company ("the Company"): Company Name: Carrington Mortgage Services, LLC c/o Wholesale Lending Dept Company Address: 1600 S. Douglass Rd, Suites 110 & 200A, Anaheim, CA 92806. I authorize the Social Security administration to verify my name and SSN to the Company and/or the Company's Agent, if applicable, for the purpose I identified. The name and address of the Company's Agent is: Automation Research Inc, DBA Data Verify , 875 Greentree Road 8 Parkway Center, Pittsburgh PA, 15220 866-895-3282.

Form SSA-89 (04-2017). Social Security Administration. Authorization for the Social Security Administration (SSA) To Release Social Security Number (SSN) Verification

Tags:

  Administration, Social, Security, 2017, Social security, Pages, Social security administration, Ssa 89, 04 2017, Page 1 of 2 social security

Information

Related search queries