Third Party Payoff Request

Anderson, Givens & Fredericks, P.A. provides owners and third-parties with the ability to submit and receive payoff statements for the communities that we represent. Any payoff provided includes the amount due at the time stated in the Payoff. In the event that full payment is not made within the time frame as directed within the payoff, additional sums may be incurred.

Each payoff statement is prepared based on the specifications of the request. The information you provide needs to be confirmed by our staff for accuracy and to ensure that the most up to date and proper information is being distributed. A substantial amount of work is necessary to ensure you receive the most up to date information because the Association guarantees the information is accurate and valid through a specific date. Accordingly, when a Payoff is requested Anderson, Givens & Fredericks, P.A., will charge a fee for their services in preparing the Payoff.

In order to fully review the information provided as well as to ensure accuracy of the information within the Payoff, please allow our office ten 10 business days to provide you with your payoff statement.

In the event a Rush Payoff is requested, an additional fee will be added to the Payoff and the Rush Payoff will be completed within seven (7) business days.

FORM – INFORMATION TO BE FILL OUT:

Full Owner Name:*

First

Last
Full Association Name:*
Relationship to Owner/Property:*
Owner:*
Bank/Mortgagee:*
Buyer:*
Property Address:*

Street Address

City

State / Province / Region

ZIP / Postal Code
Contact Address for Owner – if different than Property Address:

Street Address

City

State / Province / Region

ZIP / Postal Code
Email:*
Phone:*
Acknowledgment: RUSH PAYOFF- By clicking this box I understand that attorney’s fees will be incurred in addition to regularly occurring attorney’s fees for non-rush payoffs.*
- I understand
Notes/Comments:
Acknowledgment: I understand by marking this box and requesting a Payoff additional attorney’s fees will be incurred for work to prepare the Payoff and added to my account.*
- I understand
Acknowledgment: I understand that requesting a Payoff DOES NOT automatically cease collection efforts. Collection efforts will be on hold once the Payoff is sent to the designated address and email address and will resume upon expiration of the date stated within the Payoff.*
- I understand
Acknowledgment: I am not represented by an attorney.*
- I affirm
Acknowledgment: I have read, fully agree to, and understand the above terms as they are stated.*
- I agree
E-SIGNATURE*

(Please type in your full name as it appears on your driver’s license as proof of your identity and authorization of this form.)
IF YOU ARE NOT AN OWNER OF THE PROPERTY TO WHICH A PAYOFF IS NEEDED, THE FOLLOWING INFORMATION IS REQUIRED:
Signed release:*
Accepted file types: pdf, Max. file size: 20 MB.

Signed release from the current owner to the third party requesting the payoff specifically authorization Anderson, Givens & Fredericks, P.A. to release the requested information to the third party. (REDACT SOCIAL SECURITY NUMBERS BEFORE UPLOADING)
— Accepted file type PDF only.
Any special instructions:
Additional Documents:

In addition to the foregoing, if you obtained a Certificate of Title through a mortgage foreclosure, please provide the following information:
Recorded Certificate of Title:
Accepted file types: pdf, Max. file size: 20 MB.

(Accepted file type PDF only.)
Lis Pendens:
Accepted file types: pdf, Max. file size: 20 MB.

(Accepted file type PDF only.)
Mortgage:
Accepted file types: pdf, Max. file size: 20 MB.

(Accepted file type PDF only.)
CAPTCHA

IF YOU ARE NOT AN OWNER OF THE PROPERTY TO WHICH A PAYOFF IS NEEDED, THE FOLLOWING INFORMATION IS REQUIRED:

Additional Documents: