AUTHORIZATION FOR PAYOFF
To:
______________________________
Name of Institution Being Paid Off
Address: ______________________________
______________________________
______________________________
Phone: ______________________________
Your
___________________________
borrower(s)
___________________________
I (we) hereby authorize you to accept from Inspirus
Credit Union the payoff balance of my (our)
loan/lease. You are further authorized and
instructed to surrender to the Credit Union the
documents of title, properly endorsed and released
pursuant to RCW 46.12.170. Your failure to do
so may make you liable for $100.00 plus any loss
caused by your failure to do so under
Washington State law. For leases, a bill of sale
showing sale price, sales tax collected, and an
odometer disclosure statement must accompany the
title.
X_____________________________________
SIGNATURE/REGISTERED OWNER
DATE
X_____________________________________
SIGNATURE/REGISTERED OWNER
DATE
Your account number _______________________
VEHICLE DESCRIPTION
Year/Make
Serial Number
Odometer reading
Model
License plate number
Payoff amount
$
PLEASE SEND THE TITLE ALONG WITH A COPY OF THIS AUTHORIZATION TO:
Inspirus Credit Union
PO Box 576
Seattle, WA 98111-0576
Our borrower(s)