Payoff Request Authorization

In order to allow Brennan Title Company to request payoff information from your lender(s), you must complete, sign and fax us a Payoff Request Authorization form for each mortgage. Use the from below to create a Payoff Request Authorization that will generate to PDF for sigining and faxing.

(Please complete one of these authorizations for each mortgage or line of credit)

Re: Property Address:


Bank/Mortgage Company to be paid off:
Lender’s Name:
Phone #:
Loan Number:
Address (Customer Service address not P.O. Box where you send monthly payments):
Address:
City:
State:	Zip:

Borrowers:
Borrower 1 Name:
*Borrower 1 SSN:

Borrower 2 Name:
*Borrower 2 SSN:
* SSN - If you are not in secure location with secure internet access, please call our office with this information.
Please review your submission. If all the information is correct, press the "Generate Payoff Authorization Request" button.

	Blank Payoff Request Authorization (PDF)