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Figure: 7 TAC §155.2(c)(6)
PAYOFF STATEMENT FORM
LEGAL NOTICES
TEXAS FINANCE CODE § 343.106 REQUIRES
PAYOFF STATEMENT CONTAIN CLOSING DATE
AND DATE THROUGH WHICH PAYOFF AMOUNT
IS VALID. THESE REQUIREMENTS CANNOT BE
DELETED FROM PAYOFF STATEMENT.
TEXAS FINANCE CODE § 343.106 REQUIRES THE
IMPLEMENTING RULE TO ALLOW MORTGAGE
SERVICERS AT LEAST SEVEN (7) BUSINESS
DAYS FROM THE DATE OF RECEIPT OF PAYOFF
REQUEST TO RESPOND TO A REQUEST MADE
UNDER THE STATUTE.
ANY AMOUNT HELD IN ESCROW AT CLOSING
WILL BE SETTLED IN ACCORDANCE WITH
APPLICABLE FEDERAL LAW.
Name of Mortgage Servicer _____________________
REQUEST DATE: ____________
Name of Representative __________________________
Street or E-mail Address __________________________ SENT BY: Mail E-mail
City, State, Zip Code __________________________
Fax
LOAN INFORMATION
MORTGAGOR:
COLLATERAL:
LOAN NUMBER:
____________________________
____________________________
____________________________
NEXT PAYMENT DUE DATE: ____________
LOAN
TYPE: ____________
ORIGINAL LOAN AMOUNT: ____________
AMOUNT DUE
THIS STATEMENT REFLECTS THE TOTAL AMOUNT DUE UNDER THE TERMS OF THE
NOTE/SECURITY INSTRUMENT THROUGH THE CLOSING DATE WHICH IS _____________. If this
obligation is not paid in full by this date, then you should obtain from us an updated payoff amount before closing.
Total Principal, Interest, and other amounts due under the Note/Security Instrument:
Unpaid Principal Balance:
Interest through ____________:
Less Reductions in amount due:
_________________________:
_________________________:
_________________________:
_________________________:
TOTAL AMOUNT DUE:
$ _________________
$ _________________
$ _________________
$ _________________
$ _________________
$ _________________
$ _________________
WHERE TO SUBMIT PAYOFF FUNDS
WIRE TRANSFER
Beneficiary Name: ______________ __________________
OVERNIGHT
MAIL
Attention: _______________
Beneficiary/Receiving Bank: __________________ Company: _______________
Beneficiary Bank ABA: __________________ Address: _______________
Beneficiary Bank Account: __________________ ________________________
Special Information to Beneficiary: __________________ ________________________
______________________________
______________________________
__________________
__________________
________________________
$ _________________
OPTIONAL
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OPTIONAL SECTIONS
ORIGINAL LOAN AMOUNT:
This is an Adjustable Rate Mortgage. Under the terms of this loan the next Change Date
for the interest rate charged is _____________. We will only issue a payoff good through
the next Change Date. If the closing date is past the next Change Date an updated Payoff
Statement from us will be required.
If loan has quotable per diem interest, then “Funds received after _____________ will be
subject to an additional _________________ of interest per day.” FUNDS MUST BE
RECEIVED BY _____________ FOR SAME-DAY PROCESSING. PAYOFFS ARE NOT
POSTED ON WEEKENDS OR HOLIDAYS. INTEREST WILL BE ADDED TO THE
ACCOUNT FOR THESE DAYS.
NOTE: This Note/Security Instrument is due for payment on _____________. If payment is
not received within ________________ days of the current payment due date, a late charge of
___________ will be assessed. Please add that amount to the payoff total.
Escrow Disbursement Amounts & Dates:
Description(s): Amount(s) Held: Next Disbursement Date(s):
__________________ $__________________ __________________________
__________________ $__________________ __________________________
__________________ $__________________ __________________________
Release of Lien Processing:
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