Loan Payoff Loan Payoff Name* First Last Email* EmailIs this the Primary Borrower?* Yes No 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.) Primary Borrower Name* First Last Loan(s) Total Payoff Amount* Date of Payoff Processing* MM slash DD slash YYYY 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.NameThis field is for validation purposes and should be left unchanged.