lien payoff request form

10000 Stirling Rd #2
Cooper City, FL 33024
Phone 954-447-6947
Fax 954-447-6946
LIEN PAYOFF REQUEST FORM
Title Company Name/Law Firm:
Phone No:
Fax No:
Date:
Requested by:
Email:
File No:
Property Address:
Folio No:
1st Lien/Case No:
1st Lien Type:
1st OR Bk/Pg:
2nd Lien/Case No:
2nd Lien Type:
2nd OR BK/Pg:
Special Instructions:
Name
Title
Date