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MORTGAGE AUTHORIZATION <br />This form must be completed and signed by the property owner(s), whether a mortgage exists or not. <br />Form must be filled out completely, signed and submitted to the <br />Right of Way Division/Administrative Section immediately following first contact. <br />Job# <br />Tract# <br />Property Owner: <br />Address: <br />Telephone #: <br />Mortgage Company <br />(if no Mtg. write NONE) - <br />Address: <br />Telephone #: <br />Loan #: <br />Contact Person: <br />Due to the construction of the above -mentioned project, it may be necessary to obtain a Release. The <br />mortgagor/property owner(s) is/are aware that some or all the proceeds from this transaction may be required to <br />be applied towards the principal balance of the mortgage. <br />By signing below, Mortgagor/Property Owner (whether one or more) is authorizing the Arkansas Department of <br />Transportation to enter into the process necessary to obtain a Release and furthermore authorizes lender to <br />release the information requested. <br />The following closing agent(s) have authorization to request information and/or documentation necessary to <br />obtain a release. <br />Closing Agent: <br />Phone#: <br />Must sign even if you do not have a Mortgage <br />Date: <br />Property Owner <br />Date: <br />Property Owner <br />Closing Agent: <br />Phone#: <br />Property Owner <br />Property Owner <br />Date: <br />Date: <br />