EFTA01279933.pdf

— . _ ...,....ie34/' 11 ie 4...c.. . i Mortgage Privacy Form _.._ _. FIFTH THIRD PRIVATE BANK To provide our clients with the highest level of broadest offering, and relationship pricing. Fifth Third with our affiliates, Fifth Third Private Bank. Fifth Third Securities. Inc.. Fifth Third Mortgage Company and Fifth Third Mortgage-MI, LLC Third Mortgage"). in order to participate in the Fifth Third Private Bank Mortgage RelationshipPricing Program. borrower(s) are required grant authorization to Fifth Third to share documents and information oatheredfrom the borrower(s) between Fifth Third affiliates and legal entities by completing this Mortgage Form. granting this permission, documents and information gathered by any Fifth Third affiliate or entity may be shared and reviewed by any Fifth Third team member for the financial purpose intended. This may include providing a mortgage loan professional with access to all information obtained by or submitted to Fifth Third Bank or Fifth Third Private Bank. It may also include providing access to Fifth Third Private Bank to documents and information submitted to Fifth Third Mortgage. Please indleatet)slew your acceptance or decline in the sharing of documents and information between Fifth Third affiliates and legal entities to enable Fifth Third Private Bank to provide you with mortgage relationship pricing: Ihvowish to participate in the Private Bank Mortgage Relationship Pricing Program and understand that documentation and information will be released to Fifth Third Bank, Fifth Third Private Bank and/or Fifth Third Mortgage and related affiliate companies I/we do not wish to permission to share my/our documentation and information and thus decline to participate the Private Bank Mongage,,c..,vci,,ship Pricing Program 10/8/2014 Borrower 1 or print name Signature Date 130(1after 2 • type print name Signature Borrowers) must salt authorize a mortgage application even if the borrower(s) participates in this mortgage reutionship pricing program Ire borrower's signature above only allows for sharing of documents and information between Fiftn Thinl companies and !eget entities to better serve the borrower(s) To revoke this consent at a future date, the thorrower(s) must send a request in wrung to their Fifth Third Private Banke: or Wealth Management Advisor (WMA) asking that they no longer wish to snare documents and information and are withdrawing from the Fifth Third Pri,date Bank Mortgage Relationship Pricing Program or; air out.: ti) credit torn trota,Ooreie terortoqe voctom onialen000tirotavi Oer r ot: tititor Y I, 3ani Mr.C43:314ar.L.I. C rrV. rrr.it'it)vai, : 410stf 3,1% Asa,. PaiaN Pan Ceorazt. Orto4SM3 toe RasilonteiLltolotze tos.osee. Ft, .b10.9.hr4k;£ ere :!ace -tea Or ?tt, v."-Etsto :.-Ink - )ity am Rio, ?tar tt-rtara r4`...tol Fat Tram litolk in News* strait mono z4 rtn Tiro Paonnio Venoer EcJa Stiro'ne _tide( was tt, Trio c•trasit Bonk o 3 error Fc ft !tagUric cmarIN wearer: Sr.: .r.traN)! 71$73, ;3:33x.r3 V:NN1d5 N rtirtift /Id ,NtlneaNera,-NIte"Age, .1111$ St802141/.5 la•M114e6 'r.t.F1,1,11Sir.1.5 r, tor 421 ',row: trr: Er.'. re, %gay :oat 'rake Grp tc. kr r Marti rorArtner /ferry asariar DerArrt co 000, J* •:it. 74#1:2.c.rw!:.,,Nrycy :radio Use Only: worn no; Teter Mime( Subrut tom, eth a:, doh:renter:- it tit noRnai re MI.0 ne..tTE This can termed to me them aria taxed beck 4rormretol tr 10:113 CONFIDENTIAL SDNY_GM_00030637 EFTA 00141252 EFTA01279933