Banc of California

Abrams Garfinkel Margolis Bergson, LLP

1430 Broadway • 17th Floor • New York, New York 10018 • P: 212-201-1170

225 Broadhollow Road • Suite 102 • Melville, New York 11747 • P: 516-986-2745 • www.agmblaw.com

Complete this form when requesting an Assignment of Mortgage

Bank Name

Property type is

Requestor’s Information

Requestor's First Name

Requestor's Middle Name

Requestor's Last Name

Firm’s Name

Requestor's Direct Phone Number

Email Address

Closing Attorney Information

Closing Attorney's Name*

Closing Attorney's Firm Name*

Closing Attorney's Telephone*

Closing Attorney's Email Address*

Borrower Information

Borrower1s First Name*

Borrower1s Middle Initial

Borrower1s Last Name*

Borrower2s First Name

Borrower2s Middle Initial

Borrower2s Last Name

Borrower3s First Name

Borrower3s Middle Initial

Borrower3s Last Name

Property Address

Subject Property Street Number*

Subject Property Street*

Subject Property Apartment/Unit

Subject Property City*

Subject Property State*

Subject Property Zip*

Bank Loan Number*

New Lender Loan Information

Lender*

Full Address*

Record and Return Address

Record and Return Full Address

NOTE: At closing a legal fee of $750.00 is payable to Abrams Garfinkel Margolis Bergson, LLP. An assignment processing fee of $500.00 is due to Banc of Califonia and will be added to the payoff letter. Transaction must close within 90 days or the file will be returned to Lender and additional fees may be charged to retrieve the file again. Please accept this written authorization to order the original collateral documents for the referenced loan. Additionally, please follow all instructions of Abrams Garfinkel Margolis Bergson, LLP in ordering a payoff letter and ordering the original collateral documents.

Borrower1s Signature*

(Must be signed by borrower to process order)

Borrower2s Signature

(Must be signed by borrower to process order)

Borrower3s Signature

(Must be signed by borrower to process order)

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