Program Administrator (Sponsor) Name: CDBG Down Payment/Closing Cost Assistance Program
Program Administrator (Sponsor) Address: 619 16th Street, Moline, Illinois 61265
I hereby authorize the above Sponsor to verify my bank accounts, employment records, outstanding debts, including any present or previous mortgages, and to make other inquiries pertaining to my qualification for the CDBG Down Payment/Closing Cost Assistance Program administered by the City of Moline. Sponsor may make copies of this letter for distribution to any party with which I have a financial or credit relationships and such party may rely on such copy as if the same were an original.
Privacy Act Notice: All information collected by Sponsor or its assignees shall be used in determining whether I qualify as a prospective recipient of a forgivable loan under the CDBG Down Payment/Closing Cost Assistance Program. Such information will not be disclosed outside Sponsor except as required and permitted by law. I understand that I do not have to provide any such information, but that failure to do so may cause my application for approval as a recipient or borrower to be delayed or rejected.