Fillable State of New Jersey JUDGMENT PAYOFF REQUEST FORM (The State of New Jersey)

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State of New Jersey JUDGMENT PAYOFF REQUEST FORM (The State of New Jersey)

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State of New Jersey
DEPARTMENT OF THE TREASURY
DIVISION OF TAXATION
JUDGMENT PAYOFF REQUEST FORM
http://www.state.nj.us/treasury/taxation/
New Jersey Is An Equal Opportunity Employer
Printed on Recycled Paper and Recyclable
Please complete a separate form for each lien.
Date: ______________________
DJ # or Lien # Date filed: ______________________________________________________
FID # and/or SS #: ____________________________________________________________
Individual / Business Name: ____________________________________________________
_____________________________________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________________
Requestor: ___________________________________________________________________
Company Name: ______________________________________________________________
Phone #: _____________________________________ Fax #: __________________________
Reason for Request: ___________________________________________________________
_____________________________________________________________________________
Date Payoff Needed: ___________________________________________________________
Please be advised if you are NOT the taxpayer listed on the judgment you MUST
include a signed Taxpayer Representative Form (M-5008-R).
All payoff requests without the M-5008-R will be sent directly to the taxpayer.
Please submit this form by one of the following methods:
E-Mail: Judgments.Taxation@treas.nj.gov
Fax: (609) 292-1882
US Mail: NJ Division of Taxation
Judgment Section
PO Box 245
Trenton, NJ 08695-0245
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State of New Jersey JUDGMENT PAYOFF REQUEST FORM (The State of New Jersey)

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Completed 21 July 2020

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