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Payoff Request Form

This is an easy-to-fill payoff request form.

Time to complete

3 minutes

Eligibility

Anyone making a payoff can fill out the payoff request form.

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Questions for Payoff Request Form

1.

Borrower Name 

The answer should be a text input.
2.

Loan Number 

The answer should be a text input.
3.

Property Address

The answer should be a text input.
4.

Street Address

The answer should be a text input.
5.

City

The answer should be a text input.
6.

State / Province

The answer should be an email input.
7.

Postal / Zip Code

The answer should be a number input.
8.

Please make my payoff valid through (Payoff quotes good for maximum of 30 days) 

The answer should be a date input.
9.

Reason for Payoff Request 

The answer should be a single choice:
  1. Sale of Property
  2. Refinance Inquiry
  3. Divorce
  4. Death
  5. Others
10.

Requestor Name 

The answer should be a text input.
11.

Requestor Email Address 

The answer should be an email input.
12.

Requestor Company

The answer should be a text input.
13.

Requestor Company Address

The answer should be a text input.
14.

City

The answer should be a text input.
15.

State / Province

The answer should be a text input.
16.

Postal / Zip Code

The answer should be a number input.
17.

How do you want the payoff delivered

The answer should be a single choice:
  1. Email
  2. Fax
  3. Mailed

Similar Ideas

  • Loan payoff request form
  • Mortgage payoff request form
  • Credit card payoff request form
  • Student loan payoff request form
  • Auto loan payoff request form

Here are some FAQs and additional information
on
Payoff Request Form

How do I request a payoff request?

You can request a payoff through a BlockSurvey payoff request form.

How do I get paid?

The payoff request will be sent to the current payee and the address that is on file.

What is the purpose of a payoff?

The purpose of a payoff is to settle an outstanding debt.

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