Loan Payoff

Personal Information

First Name

Last Name

Is this the Primary Borrower?

YesNo

Loan ID(s)

Note: If paying off more than one loan, please input all loan IDs and include the total payoff amount for all loans.

Loan(s) Total Payoff Amount

Date of Payoff Processing

On what business day do you authorize SELF to process your payment?

Bank Name

Financial Institution Routing Number

Financial Institution Account Number

ACH Authorization

I authorize the processing of my Loan Payoff Payment submission from my check/savings account listed above. By submitting this form, I am acknowledging that I am authorized to submit the above information and that all information submitted is true and correct. Additionally, I acknowledge that I have verified my Loan Payoff amount with SELF either by phone, email, or through the SELF Client Loan Portal.

Note: SELF Accounting Department will submit the Payoff Settlement document via email. Please ensure your correct email is provided.