Payoff Request Form

Payoff Request Form
Open Notice

X

Notice to requestor:

Please obtain an updated payoff quote 48 hours prior to remitting funds as payments and escrow disbursements will cause the figures to change.

If the loan is established on autopay, we must receive a verbal cancelation request or payoff funds at least 3 business days prior to the draft date prevent the draft from occurring.

For questions, please contact Flat Branch Customer Service: 1-877-350-0350 or servicing@fbhl.com
Borrower Name*

First NameLast Name
Loan Number*
Property Address*

Street Address

Street Address Line 2

CityState

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

MonthDayYear
Date
Reason for Payoff Request*

Sale of PropertyRefinance Inquiry
Requestor Information
Requestor Name*

First NameLast Name
Requestor Email Address*
example@example.com
Borrower Signed Authorization*

Browse Files

Cancelof
Requestor Company*
Requestor Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Net Escrow (Flat Branch Internal Request Only)

NoYes
Will any scheduled escrow items be paid at closing?

YesNo
Scheduled escrow items to be paid at closing:

TaxesInsuranceBoth
How do you want the payoff delivered

EmailFaxMailed
Email Payoff To:
example@example.com
Fax Payoff To:

Area CodePhone Number
Mailing Payoff To:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Area Sales Manager*
Loan Officer*
ASM
Should be Empty:

Notice to requestor: