Payoff Request Form. First name, Last name, Account Number (optional), Phone, Street address, Apartment, suite, etc.Please fill out the form below or see additional contact information below this form. The amount you pay and the length of time to repay your loans will vary depending on the repayment plan you choose. Typically, you will need to speak with your lender to find out what programs are available to you and to begin the process of modifying your mortgage. What are the address and hours of the Nassau County Clerk's Office? The Nassau County Clerk's Office is located at 240 Old Country Road, Mineola. You need to fill out a form to be considered for "Poor Person Relief. Contact Ronald Weiss, Esq. GRANT ASSISTANCE: Nassau County EAHP funds are essentially a zero-interest deferred loan.