MOR-01 Written Authorization and Waiver


Form 1 of 9

Urban League of Philadelphia

Waiver of Privacy: I do hereby authorize The Urban League of Philadelphia (ULP) to negotiate on my behalf and release information about my housing matter, when appropriate, in any third party negotiations and communications with lenders, landlords, or other appropriate entities in an effort to resolve the current and/or future issues related to this transaction.

All information pertaining to my housing matter is kept confidential and shall not be disclosed to any entity without my authorization.

All information ordered by the Court or otherwise required by law to be released will be so released. It is understood that funding sources may review information contained in agency files as a random review process. Also, demographic information is provided to funding sources on each client. I also allow ULP to conduct a follow-up call with me related to program evaluation. I authorize ULP to submit my client- level information to the Data Collection System.

Credit Report Authorization: By signing below I/we also authorize The Urban League of Philadelphia to pull my/our credit report and review my /our credit file for information inquiry and counseling purposes.

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Signature Certificate
Document name: MOR-01 Written Authorization and Waiver
lock iconUnique Document ID: fdfb9637289255416bf17c2a12d8273f702f2263
Timestamp Audit
April 30, 2019 10:21 pm ESTMOR-01 Written Authorization and Waiver Uploaded by David Bruggink - david.bruggink@gmail.com IP 192.168.95.1, 172.17.0.1
July 3, 2019 9:59 pm ESTDeserie Hill - dhill@urbanleaguephila.org added by - as a CC'd Recipient Ip: 192.168.95.1, 172.17.0.1
July 5, 2019 10:16 pm ESTULP Housing - housing@urbanleaguephila.org added by - as a CC'd Recipient Ip: 192.168.95.1, 172.17.0.1
July 6, 2019 12:45 pm ESTULP Housing - housing@urbanleaguephila.org added by - as a CC'd Recipient Ip: 192.168.95.1, 172.17.0.1
July 6, 2019 1:39 pm ESTULP Housing - housing@urbanleaguephila.org added by - as a CC'd Recipient Ip: 192.168.95.1, 172.17.0.1
July 6, 2019 1:42 pm ESTULP Housing - housing@urbanleaguephila.org added by - as a CC'd Recipient Ip: 192.168.95.1, 172.17.0.1
July 6, 2019 1:44 pm ESTULP Housing - housing@urbanleaguephila.org added by - as a CC'd Recipient Ip: 192.168.95.1, 172.17.0.1
July 6, 2019 1:46 pm ESTULP Housing - housing@urbanleaguephila.org added by - as a CC'd Recipient Ip: 192.168.95.1, 172.17.0.1
July 6, 2019 10:14 pm ESTULP Housing - housing@urbanleaguephila.org added by - as a CC'd Recipient Ip: 192.168.95.1, 172.17.0.1
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