#4155 @001 Enter the name of the party requesting loan balance: @455 Enter first line of address of party requesting balance: @456 Enter second line of address of party requesting balance: @457 Enter final line of address of party requesting balance: @002 Enter the name of the borrower: @458 Enter address of property: @459 Enter the city, state of residence of borrower: @460 Enter the date of preparation of estoppel: !461 Enter the loan balance: !462 Enter the per diem: @463 Enter the date of last payment: @464 Enter last date when pay off is correct: @003 Enter name of owner of the loan: @465 Enter title of the person providing estoppel: @466 Enter address of loan owner: @467 Enter the city, state of loan owner: #end control section #4155 /* Para. 4155: Estoppel letter */ Estoppel Letter TO: @001 @455 @456 @457 REGARDING: @002 Property located at: @458 @459 The balance due upon this mortgage as of @460 is $ @461 (!461 dollars). The per diem is $ @462 (!462 dollars). The mortgage was last paid on @463. The figures in this estoppel are effective until @464. Dated: ______________________ For: @003 By: _______________________________________ As: @465 @466 @467