BCWSA Refinance Request Any person(s) refinancing or mortgaging a property, located within the Authority’s service territory, needs to fill out an application for a payoff on the form below (“refinance”), at least ten (10) days prior to the refinancing.* Indicates a required fieldOwner of Record*Property Address (Service Address)* Address Line One Address Line Two City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Code Date Request Needed* MM slash DD slash YYYY Tax Parcel NumberTitle Company Representative*(or party responsible for final payment)Title Company Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Title Company Phone*Title Company Email* The cost of an account payoff for refinance is $35.00. Should settlement be cancelled or postponed,contact our office immediately at 215-343-2538 option 3.* I have read, understood and fully agree to the above terms and charges. Furthermore, the signature below indicates acceptance of full responsibility for the payment of same.Signature*NameThis field is for validation purposes and should be left unchanged.
