Mortgage Payoff Affidavit Form
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1MORTGAGE PAYOFF AFFIDAVIT
STATE OF NEW YORK
TITLE NO. ________________
COUNTY OF
________________________________ AND _________________________________
being duly sworn depose/s and say/s:
1)
That I/We are the owner/s of the premises, known as:
______________________________________________________________________;
This day being conveyed to: __________________________________________
______________________________________________________________________.
2)
I/We am/are aware of the payoff letter/s of : ______________
__________________________________; dated ______________________________
showing the prior balance and the per diem, required to satisfy the
existing mortgage/s and have reason to believe the same/they is/are
correct in all respects.
I/We am/are also aware of the fact that ALL NEW YORK
3)
TITLE AGENCY, INC. (hereinafter referred to as ANY) , as escrow
agent to pay, is subjecting itself to a risk of having to make good
any deficiency
by reason of
error and
the fact
that
the
payoff
letter/s
may
not be deemed
as estoppel/s nor does ANY desire to
subject itself to
possible litigation
in order to establish such
fact.
4)
I/We am/ are also aware of the fact that ANY may not be
able to locate my/our whereabouts so as to collect from me/us any
possible
payments
required
by
the
mortgagee/s
to
obtain
the
satisfaction/s or discharges/s.
5)
To induce ANY to accept such payoff letter/s and as
escrowee,
I/We agree to indemnify and hold ANY harmless for so
doing.
I/We further agree to repay ANY or pay directly to the
mortgagee/s as ANY directs such monies as ANY deems in their sole
judgement necessary to perform the purpose of this escrow.
6)
To assure ANY of my/our availability for the purpose of
reimbursing ANY under paragraph 5, I/We freely furnish it with the
following information;
SOCIAL SECURITY NO. : ____________________________
SOCIAL SECURITY NO. : ____________________________
My/Our Employer’s Company and Address is: ___________
________________________________________________________________________
7)
I/We state to ___________________________________________that
I/we am/are not moving out of State at this time and that my/our
permanent address after selling my/our above premises will be:
________________________________________and____________________________
8)
I n t h e e v e n t t h a t
I / W e l e a v e t h e S t a t e , I / W e c a n b e
r e a c h e d t h r o u g h t h e f o l l o w i n g : ______________________________________
________________________________________________________________________
( I n d i c a t e r e l a t i o n s h i p - p a r e n t , c h i l d r e n , e t c . )
S I G N E D :
______________________________
S I G N E D :
______________________________
Sworn to before me this _______
day _______________, 20___
____________________________
N o t a r y P u b l i c
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