Payoff Authorization Form

In order to allow The Law Office of Russell C. Petersen to request payoff information from your lender(s), you must complete, sign and fax/email us a Payoff Request Authorization form for your existing mortgages. Use the form below to create a Payoff Request Authorization Form.

Property/Our File Information

Re: (Address)
City:   State:   Zip:
Our File #:  

Existing Mortgage Lender(s)

Lender/Payoff 1:
Lender Name:
Loan #:
Lender/Payoff 2:
Lender Name:
Loan #:
Lender/Payoff 3:
Lender Name:
Loan #:


Borrower 1 Name:
Borrower 1 SSN:
Borrower 2 Name:
Borrower 2 SSN:
Please review your submission. If all the information is correct, press the "Generate Payoff Authorization Request" button.