AMD Payoff Request Form - Arvest Bank

PAYOFF REQUEST

DATE OF REQUEST:_____________________________________________ REQUESTER'S NAME:___________________________________________ COMPANY NAME: ______________________________________________ PHONE#: __________________________ FAX#: ______________________ EMAIL: ________________________________________________________ CUSTOMER NAME AND/OR SS#: _________________________________ LOAN NUMBER: ________________________________________________ PROPERTY ADDRESS: ___________________________________________ ________________________________________________________________

REASON FOR PAYOFF: SOLD, REFI W/ ARVEST, REFI W/OTHER INSTITUTION, OTHER:

DATE OF PAYOFF:

Please fax information, along with customer written authorization, to Arvest Bank ? Mortgage Division at 479-757-8922. A convenience fee may be assessed for any payoff statement sent via fax.

PO BOX 399 * LOWELL, AR * 72745-0399 * (800) 232-5524 * FAX (479) 757-8922 *

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