You are on page 1of 1

Granger Motors Inc

AUTHORIZATION FOR LOAN PAYOFF RELEASE

DATE:_______________
LENDER:________________________________________
LOAN # :________________________________________
CUSTOMER:__________________________________________________
SS# :__________________________________
VEHICLE YEAR:_______________________
MAKE:________________________________
MODEL:_______________________________
I hereby authorize the release of the loan payoff on the vehicle described above. Please
fill in the information below for a 10 day payoff from the date listed above and
Fax back to: 515-999-2385.
X____________________________________ _________
Signature
Date
10 DAY PAYOFF:_________________
LOAN # :_________________________
QUOTED BY :_____________________

You might also like