4745 Nicholas Point Drive
Grove City, OH 43123
phone: 614-899-9919
fax: 614-899-9190
Mortgage Broker Number:
MB 802616 UI 219001
Knight Wagner Mortgage is a residential mortgage loan company serving central Ohio. We handle first mortgage loans for refinancing and purchasing of owner occupied properties.

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To Whom It May Concern:

1. I/We have applied for a mortgage loan from Knight Wagner Mortgage Co., Inc. As part of the application process, Knight Wagner Mortgage Co., Inc. 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 program.

2. I/We authorize you to provide to Knight Wagner Mortgage Co., Inc., and to any investor to whom Knight Wagner Mortgage Co., Inc. 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.

Knight Wagner Mortgage Co., Inc. or any investor that purchases the mortgage may address this authorization to any party named in the loan application.

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

4. Your prompt reply to Knight Wagner Mortgage Co., Inc. or the investor that purchased the mortgage is appreciated.

Financial Privacy Act Notice

The Federal Right to Financial Privacy Act requires that all applicants be informed of the purpose and uses to be made of the information which is solicited. The following is a statement of purpose and use.


The information requested in the loan is considered relevant and necessary to determine your credit worthiness for the loan for which you are applying.


The information will be used in evaluating your loan application

Effect of Non-Disclosure

Disclosure of the requested information is voluntary. No penalty will be assessed for failure to respond. However, the decision as to approval of your loan request must be made on the basis of information supplied by you. Incomplete information could result in delay or denial of your loan request.

This is notice to you, as required by the right to Financial Privacy Act of 1978, that the Department of Housing and Urban Development, the Department of Veteran Affairs Loan Guaranty Division, or a permanant mortgage guaranty company has a right of access to financial records held by a financial institution in connection with the consideration or administration of assistance to you. Financial records involving your transaction will be available to the above mentioned agencies without further notice or authorization but will not be disclosed or released to any other government agency or department without your consent except as required or permitted by law.

Reg B-Appraisal Request

You have a right to a copy of the appraisal report used in connection with application for credit. If you wish a copy, please write to us at 2600 Corporate Exchange Dr. Suite 116 Columbus, Ohio 43231. We must hear from you no later than 90 days after we notify you about the action taken on your loan application, or from the date you withdraw your application.

All applicants must sign this form.
For the time being, print off this form and FAX or mail it to our office.

4745 Nicholas Point Drive
Grove City, OH 43123
phone: 614-899-9919
fax: 614-899-9190