Payoff Request Form Please complete this form in full. We will not be able to process incomplete forms. This form is for use by individuals / companies other than the property owner. There is a charge of $25.00 per payoff. This charge must be received before a payoff is provided. Please provide credit card payment information below. Alternatively, please make check payable to Riah Capital Management, LLC, and forward along with your completed payoff request form to Riah Capital Management, LLC; One Alliance Center, 4th Floor; 3500 Lenox Road; Atlanta, GA 30326. Contact Information Name: Company: Type: □ Closing Attorney □ Lender □ Other: __________________________ Address: City, State and Zip: Phone: Fax: Email: Return payoff via: □ Email □ Fax □ Mail *Payoffs will be returned via the method indicated above within 24-­‐48 hours. Property Information Parcel ID: County: Property Address: Owner Name: Tax Year(s): Payoff Good Through Date: Payment Information Name on Credit Card: Credit Card Number: Expiration: Signature: CVV.Code:
Billing.Zip.Code:
.
Please fax completed request to 404-­‐926-­‐4875, or email to [email protected].
If you have questions, please contact our Payoff Request line at 404-­‐926-­‐4675.