Payoff Request Form


  1. Complete this form CERTIFICATION-REQUEST-FORM-2019.
  2. Print or save the form if sending it via email.
  3. Please submit this payoff request either by U.S. Postage Paid, First Class Mail; Fax or electronic mail.
  4. If submitting by email, please email to:
  5. If payoff request is sent by Fax or Email, please note that lien certification will not be Issued until payment of fee has been received.

Fee for lien certification is $15.00 PER PARCEL.

Please make check payable and mail to:     Dimmich & Dinkelacker, P.C.  2987 Corporate Court, Suite 210. Orefield, PA  18069