Payoff Authorization Form | Atlantic Title Firm Florida

This authorization lets us contact your mortgage lender/servicer to obtain your exact payoff figure. You do not have to enter your loan account number here — for your security you may leave it blank, and we'll obtain it through a secure channel. Please do not enter your Social Security number on this form.

Borrower / Owner

Borrower Full Name *

Co-Borrower Full Name (if any)

Email *

Cell Phone *

Property

Property Address *

Current Mortgage / Lender

Tell us who holds your loan so we know which lender to contact for the payoff.

Lender / Servicer Name *

Lender Phone (if known)

Loan / Account Number (optional — speeds processing)

Second Lender / HELOC (if any)

Second Loan / Account Number (optional)

Authorization & Signature

I/we, the undersigned borrower(s) and/or owner(s) of the property described above, hereby authorize the mortgage lender(s) and loan servicer(s) named above, and their successors and assigns, to release to Atlantic Title Firm and its designated agents any and all information concerning the mortgage loan(s) secured by that property — including but not limited to the current payoff balance, per-diem interest, escrow balances, loan status, and any other information necessary to facilitate the closing of this transaction. This authorization remains in effect until the closing is complete. A photocopied, faxed, or electronically transmitted copy of this authorization shall be as valid as the original.

Sign Here *

Draw your signature with your mouse or finger.

Printed Name (legal) *

Date

I am the borrower (or an authorized signer) named above, and I authorize Atlantic Title Firm to obtain the payoff and loan information described. I agree that my electronic signature above is legally binding and has the same effect as a handwritten signature.