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Request For Payoff Information - Ohio
| Request For Payoff Information Form. This is a Ohio form and can be used in Business Services Attorney General Office Statewide . |
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Collections Enforcement Section 150 E. Gay St., 21st Fl. Columbus, OH 43215 Telephone: (614) 466-8360 www.ag.state.oh.us REQUEST FOR PAYOFF INFORMATION [to be completed by realtor or title company] TO: FROM: COLLECTIONS ENFORCEMENT SECTION, ATTORNEY GENERAL OF OHIO FAX NO. 614-644-7106 ________________________________________________________(NAME) ________________________________________________________(MAILING ADDRESS) ________________________________________________________ FAX NO. ________________________________________________ DATE: ___________________ CONSENT BY INDIVIDUAL(S): I/we, , give the Attorney General of Ohio permission to release to : (1) information related to debts I/we owe the State of Ohio which have been certified to the Attorney General for collection; and (2) document(s) which effect a release of lien(s) related to those debts. Signed: Dated ____________________ Dated ____________________ CONSENT BY CORPORATION, PARTNERSHIP, OR OTHER BUSINESS ENTITY: , by its (name of company) permission to release to related to those debts. Signed: Dated ____________________ SEARCH CRITERIA ____________________________________________________________________________________________ Full Name(s) of Debtor(s) ____________________________________________________________________________________________ dba(s),fka(s),etc. ____________________________________ Current Mailing Address ____________________________________ City, State, Zip _____________________________________________________ Property Address _____________________________________________________ City, State, Zip (title) : (1) information related to debts it owes the State of Ohio , gives the Attorney General of Ohio which have been certified to the Attorney General for collection; and (2) document(s) which effect a release of lien(s) Current Telephone Number(s):___________________________________________________________________ Tax ID & Social Security Number(s):_______________________________________________________________ Assessment Serial Number(s): __________________ __________________ __________________ __________________ __________________ __________________ BWC Risk/Policy Number(s) __________________ __________________ __________________ Additional information which might facilitate the search [note: attaching copies of recorded liens or a summary of the title search is helpful but not required]: American LegalNet, Inc. www.FormsWorkflow.com RESPONSE TO REQUEST FOR PAYOFF INFORMATION [top portion to be completed by realtor or title company] TO: _____________________________________________________________(NAME) __________________________________________________(MAILING ADDRESS) ________________________________________________ FAX NO. ________________________________________ FROM: RE: COLLECTIONS ENFORCEMENT SECTION, ATTORNEY GENERAL OF OHIO Name(s) of debtor(s): ________________________________________________ ____________________________________________________________________ Tax ID & SSN(s): _____________________________________________________ Risk No(s): _________________________________________________________ [this portion to be completed by Collections Enforcement Section] We have conducted a search of our records based on the search criteria provided. As set forth below, we have located liened and unliened debts certified to the Attorney General for collection. Please be advised that : (1) praecipes issued to the clerk on pending liens may be filed by the time of closing; (2) any currently unliened debts may be liened by the time of closing; and (3) additional certified and uncertified debts may exist which were not located during our search. Payoff Balance of Filed Lien(s) $ (see attached detail) Payoff Balance of Lien(s) Issued (but not yet filed per our records) $ (see attached detail) Payoff Balance of Unliened Debts $ (see attached detail) Total Payoff Good Thru ___/___/___ Date of Search ___/____/___ $ Search conducted by: ___________________________ Make check payable to Attorney General of Ohio and send to Collections Enforcement Section, Attn. Payoff Staff, 150 East Gay St., 21st Floor, Columbus, Ohio 43215. All tax identification numbers and risk numbers noted on the attached detail must accompany the payment to ensure that the correct accounts are credited. The current balance due is available for viewing at http://www.ag.state.oh.us/ Account and CRN numbers from the Attorney General letter are needed to access the information. If an account is assigned to special counsel attorneys, additional fees may apply. American LegalNet, Inc. www.FormsWorkflow.com Name(s) of Debtor(s): ______________________________________________ DETAIL: PAYOFF BALANCE OF FILED LIEN(S) Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Reference Number _____________________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ Amount _________________ SUBTOTAL $ DETAIL: PAYOFF BALANCE OF LIEN(S) ISSUED (BUT NOT YET FILED PER OUR RECORDS) Reference Number _____________________________ Amount _________________ Reference Number _____________________________ Amount _________________ Reference Number _____________________________ Amount _________________ Reference Number _____________________________ Amount _________________ Reference Number _____________________________ Amount _________________ Reference Number _____________________________ Amount _________________ SUBTOTAL $ Note: Release(s) will be issued within 10 days after we receive payment in full for the lien(s) and we receive from the Clerk/Recorders Office th
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