Authorizations, Disclosures & Signatures
Typed names and checked boxes serve as electronic acknowledgment for this online application.
Information Release: I give permission for MiraCit Development Corporation, Inc. Economic Empowerment Services to obtain information or copies of my financial, legal, or other pertinent file to facilitate my case. I understand that counseling services or assistance may be offered by other providers and I am under no obligation to utilize MiraCit services regardless of counselor recommendations.
Letter of Authorization / HUD: I authorize MiraCit Development Corporation, Inc. Economic Empowerment Services to speak with, obtain information, and/or copies of pertinent file information regarding my housing case file. For pre-purchase and rental counseling, I authorize client-level information to be submitted to HUD’s Housing Counseling System for monitoring, compliance, and evaluation.
Conflict of Interest and Disclosure: I acknowledge receipt and understanding of MiraCit’s conflict of interest and disclosure information, including that counseling does not guarantee financial assistance or mortgage financing and that clients are free to choose lenders, products, and homes.
Privacy Policy: I understand that MiraCit protects nonpublic personal information and may disclose information as permitted by law, for counseling, grant compliance, monitoring, and evaluation unless I choose to opt out.
Home Inspection Notice: I understand that a home inspection is not automatic, an appraisal is not a home inspection, and I must choose whether to obtain and schedule a home inspection.
Photo Release: I grant MiraCit Development Corporation, Inc. the right to take and use photographs of me for lawful purposes such as publicity, illustration, advertising, and web content.
