Establishing secure connection…Loading editor…Preparing document…

Borrower Certification and Authorization Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Borrowers' Certification and Authorization

CERTIFICATION

The Undersigned certify the following:

1. I/We have applied for a mortgage loan through . In applying for the loan, I/We completed a loan application containing various information on the purpose of the loan, the amount and source of the down payment, employment and income information, and the assets and liabilities. I/We certify that all of the information is true and complete. I/We made no misrepresentations in the loan application or other documents, nor did I/We omit any pertinent information.

2. I/We understand and agree that reserves the right to change the mortgage loan review processes to a full documentation program. This may include verifying the information provided on the application with the employer and/or the financial institution.

3. I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements when applying for this mortgage, as applicable under the provisions of Title 18, United States Code, Section 1014.

AUTHORIZATION TO RELEASE INFORMATION

To Whom It May Concern:

1. I/We have applied for a mortgage loan through . As part of the application process, and the mortgage guaranty insurer (if any), may verify information contained in my/our loan application and in other documents required in connection with the loan, either before the loan is closed or as part of its quality control program.

2. I/We authorize you to provide to and to any investor to whom may sell my mortgage, any and all information and documentation that they request. Such information includes, but is not limited to, employment history and income; bank, money market and similar account balances; credit history; and copies of income tax returns.

3. or any investor that purchases the mortgage may address this authorization to any party named in the loan application.

4. A copy of this authorization may be accepted as an original.

Borrower Signature

SSN:

Date:

Co-Borrower Signature

SSN:

Date:

EQUAL CREDIT OPPORTUNITY ACT

APPLICATION NO:

PROPERTY ADDRESS:

The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act.

We are required to disclose to you that you need not disclose income from alimony, child support or separate maintenance payment if you choose not to do so.

Having made this disclosure to you, we are permitted to inquire if any of the income shown on your application is derived from such a source and to consider the likelihood of consistent payment as we do with any income on which you are relying to qualify for the loan for which you are applying.

(Applicant)

(Date)

(Applicant)

(Date)

(Applicant)

(Date)

(Applicant)

(Date)

NOTICE TO APPLICANT OF RIGHT TO RECEIVE COPY OF APPRAISAL REPORT

APPLICATION NO:

PROPERTY ADDRESS:

You have the right to receive a copy of the appraisal report to be obtained in connection with the loan for which you are applying, provided that you have paid for the appraisal. We must receive your written request no later than days after we notify you about the action taken on your application or you withdraw your application.

If you would like a copy of the appraisal report, contact:

Truth-In-Lending Mortgage
100 E Street, Suite 108
Santa Rosa, CA 95404

Applicant

Date

Applicant

Date

Applicant

Date

Applicant

Date

THE HOUSING FINANCIAL DISCRIMINATION ACT OF 1977 FAIR LENDING NOTICE

DATE:

APPLICATION NO:

PROPERTY ADDRESS:

It is illegal to discriminate in the provisions of or in the availability of financial assistance because of the consideration of:

1. Trends, characteristics or conditions in the neighborhood or geographic area surrounding a housing accommodation, unless the financial institution can demonstrate in the particular case that such consideration is required to avoid an unsafe and unsound business practice; or

2. Race, color, religion, sex, marital status, national origin or ancestry.

It is illegal to consider the racial, ethnic, religious or national origin composition of a neighborhood or geographic area surrounding a housing accommodation or whether or not such composition is undergoing change, or is expected to undergo change, in appraising a housing accommodation or in determining whether or not, or under what terms and conditions, to provide financial assistance.

These provisions govern financial assistance for the purpose of the purchase, construction, rehabilitation or refinancing of a one-to-four unit family residence occupied by the owner and for the purpose of the home improvement of any one-to-four unit family residence.

If you have any questions about your rights, or if you wish to file a complaint, contact the management of this financial institution or the agency noted below:

I/we received a copy of this notice.

Enter text✕
Prepare your document for signing right on this page
  • 01 Edit the text and complete the fields
  • 02 Click Sign Now and on the next screen add recipients and signature fields in SignNow
  • 03 Start your free trial to sign and send your doc
Sign Now

What the Borrower Certification and Authorization Form Is and When it's Used

The Borrower Certification and Authorization Form documents a borrower's attestations and grants a lender permission to verify information relevant to a credit or loan application. Typical attestations cover accuracy of personal and income details, tax identification numbers, and authorization to obtain credit reports, employment verifications, and tax transcripts. Lenders use the form during underwriting, closing, and post-closing compliance checks. The form supports auditability by recording signer's identity, date, and method of signature and often accompanies other loan documents such as promissory notes, security agreements, and disclosures.

Why this Form Matters for Lenders and Borrowers

A clear Borrower Certification and Authorization Form reduces underwriting delays, documents borrower consent for third-party checks, and creates an auditable record of representations and permissions that supports compliance and fraud prevention.

Why this Form Matters for Lenders and Borrowers

Who Typically Completes and Reviews This Form

Common participants include borrowers, loan officers, closing agents, and compliance teams who need an auditable consent and certification record.

  • Borrower: Primary applicant who attests to identity, income, and TIN correctness and grants authorization for verifications.
  • Loan Officer / Originator: Requests the form and confirms completion before submitting application to underwriting.
  • Compliance / Servicing Team: Retains the signed form for audit, servicing, and regulatory review where required.

Knowing each participant's role helps ensure correct signing order, required attestations, and retention under applicable rules.

Step-by-Step: How to Complete and Submit the Form

Follow this order to minimize processing delays and to create a complete audit trail for underwriting and compliance.

  • 01
    Gather Documents: Collect ID, pay stubs, and TIN documentation before starting.
  • 02
    Complete Fields: Fill each required field using specified formats.
  • 03
    Sign and Date: Apply signature, printed name, and date in the signature block.
  • 04
    Return to Lender: Send the signed form to the loan officer or upload to the loan portal.

Essential Sections to Include in a Professional Borrower Certification and Authorization Form

A comprehensive form balances clear borrower statements, narrowly scoped permissions, and audit elements that demonstrate intent, attribution, and retention capability under ESIGN and UETA.

Borrower Attestations

Explicit statements the borrower certifies to the accuracy of personal, income, and tax information and acknowledges penalties for false statements.

Scope of Authorization

Precise list of third-party checks permitted (credit reports, employment, tax transcripts) and time-limited consent language for each.

TIN Certification

Clear TIN/SSN certification block that explains backup withholding consequences and confirms taxpayer identification.

Signature and Date

Signer name, signature field, and date; include checkboxes for electronic vs handwritten signature method when applicable.

Verification Instructions

Lender instructions for acceptable ID, required supporting documents, and how to submit completed items to underwriting.

Audit Trail Info

Space for recording signer IP, authentication method, and verifier initials to support later audits or regulatory review.

Key Data Points Required on the Form

Borrower Name: Full legal name
Tax ID: SSN or EIN
Contact Details: Address and phone
Date of Birth: MM/DD/YYYY
Scope Checks: Credit, employment, tax
Signature: Signed and dated

Configuring an Online Workflow for This Form

Set fields, authentication, and routing before sending to reduce signer friction and ensure compliance with consumer-consent rules.

Field Configuration
Signer Authentication Email + SMS code or KBA
Conditional Fields Show employment fields only if employed
Routing Order Borrower then loan officer then compliance
Retention Policy Store signed PDF + audit trail

Where to Send or File the Completed Form

Understanding the final destinations helps maintain chain-of-custody and ensures required parties receive a copy for underwriting and servicing.

  • Loan Originator: Submit the signed form to the originating loan officer.
  • Underwriting: Attach form to the loan file for underwriting review.
  • Servicing Department: Keep a copy for loan servicing and audit.
  • Credit Agencies: Use authorization to obtain credit report as needed.

Technical and Platform Considerations for Digital Completion

Choose a platform that supports secure PDFs, audit trails, and signer authentication methods appropriate for the transaction and regulatory environment.

  • File Formats: PDF and DOCX support
  • Integrations: Salesforce, NetSuite, Google Workspace
  • Authentication: Email, SMS, KBA options

Typical Timelines and Processing Expectations

Processing times vary by lender and verification method. Use realistic service-level times to set borrower expectations and avoid rework.

Submission Timing:

Submit with the initial loan application.

Underwriting Response:

Lenders commonly respond within 3–10 business days.

Credit Report Turnaround:

Credit agency responses are usually immediate to 48 hours.

Employment Verification:

May take up to 10 business days for manual checks.

Tax Transcript Requests:

IRS transcripts can take several days to several weeks.

Common Mistakes That Delay Processing

  • Submitting an incorrect or incomplete TIN triggers backup withholding and requires reissue of tax forms.
  • Using an email-only authentication for high-risk loans can increase fraud risk and slow lender approvals.
  • Failing to date the signature or using inconsistent date formats can void time-limited authorizations.
  • Omitting scope limits and granting overly broad authorizations can create regulatory and privacy risk.

Penalties and Legal Risks of an Incorrect or Missing Form

False Statements: Possible civil and criminal liability
Backup Withholding: Triggered by incorrect TIN
Regulatory Fines: Compliance failures may incur fines
Loan Delay: Processing and closing postponed
Reputational Risk: Trust and borrower relations harmed
Recordkeeping Failure: Audit exposure without retention

eSignature Vendor Pricing Comparison for Borrower Forms

Comparison of common vendor starting prices and key features relevant to high-volume loan document workflows; signNow is listed first per vendor ordering requirements.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes (Business Premium) Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Best Practices to Reduce Risk and Speed Processing

Adopt these practices to improve completeness, maintain legal defensibility, and reduce manual rework across lending workflows.

Use Clear, Narrow Authorization Language
Limit authorization scope to the checks you actually need; overly broad consents increase privacy and compliance risk and may complicate third-party responses.
Require Strong Signer Authentication
For loans with elevated fraud risk, use multi-factor authentication or KBA to strengthen attribution and reduce challenge risk during audits.
Preserve Audit Trails
Store the signed PDF and an immutable certificate of completion showing timestamps, IP addresses, and authentication method for at least the retention period.
Include ESIGN Consumer Disclosure When Required
For consumer-facing authorizations, present an ESIGN disclosure and capture consent per 15 U.S.C. §7001(c) before accepting an electronic signature.

Real-World Examples of Use in Lending and Servicing

The following short examples show how organizations use borrower certifications to streamline verifications and document consent.

Martin Properties

A regional mortgage broker digitized certification forms to reduce in-person closing steps and accelerate closings.

  • Used conditional fields to collect only applicable verifications.
  • The broker preserved signed PDFs and audit trails to support post-closing warranty reviews and to meet investor due diligence requirements.

Fertility Centers of Illinois

A medical financing partner required borrower authorization for tax and employment checks tied to loan offers.

  • Integrated eSignature in the loan portal.
  • The organization kept HIPAA considerations separate, adding limited data-access language and a BAA to govern protected health information disclosures.

Frequently Asked Questions and Troubleshooting

Answers to common questions about correct completion, electronic signing, authentication, and record retention for borrower certifications.


Need help? Contact support

Explore Templates

New York Sealing Records New York Temporary Order of Protection Order Protection Form
be ready to get more
Join over 28 million airSlate SignNow users
Sign Now
Company
Forms
Pricing
Resources
Knowledge base
Other Products
© 2026 airSlate Inc. All rights reserved.