BCWSA Refinance Request

Refinance Request Form

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 required fields

URL

This field is for validation purposes and should be left unchanged.

Owner of Record*

Property Address (Service Address)*

Address Line One Address Line Two City State Zip Code

Date Request Needed*

Tax Parcel Number

Title Company Representative*

(or party responsible for final payment)

Title Company Address*

Street Address Address Line 2 City 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*

Please type your name here to serve as a digital signature: