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SPECIFIC
POWER OF ATTORNEY
(I, We,) the undersigned, am are the claimants entitled to be paid by the Distributive Shares
Branch of United States Department of Housing and Urban Development (HUD),
Washington D.C. 20410 in the amount of: $ generated by the termination of a
FHA mortgage insurance on FHA Case Number ______________________
On property located at: _____________________________________________________
_______________________________________________________________________
(I, We,) understand that a U.S. Treasury check which is payable to the undersigned, in this
amount, would ordinarily be sent to (me, us) at (my, our) home address of:
_______________________________________________________________________
_______________________________________________________________________
However: (I, we,) here by authorize and direct HUD to deliver the US Treasury Check in payment of
said claim to: _____Scott Holbert ___, located at 316 Watermelon Hill Rd.
Eastover, SC 29044-9321
It is understood that HUD will honor this Specific Power of Attorney only when submitted with the form
HUD-27050-B and item 4 of the form HUD-27050-B shows the Third Party Tracer's Address.
It is expressly understood that HUD will honor this Specific Power of Attorney does not authorize nor
empower anyone other than the undersigned to affix (my, our) signature(s) to the check.
Signed, this ______ day of _______________________ 20 _____
___________________________ _______________________ Date 20_____
WITNESS SIGNATURE
___________________________ _______________________ Date 20_____
WITNESS SIGNATURE
State of:
County of:
On this ______day of ____________, 20____, Before me, a Notary Public, in an for said county,
personally came and appeared ____________, and _____________, personally known to me to be
the same person(s) described in and who executed the above power of attorney and acknowledged
the signing thereof to be (his)(their) volumtary act and deed for the uses and purposes therein mentioned.
Personally appeared before me ____________________________________________the
____________________________________
(NOTARY PUBLIC)
(SEAL)
My Commission expires:
