In the payoff demand statement, the beneficiary must state the amount of the unpaid balance and interest rate together with the total amounts. Before you start Document your costs You'll need to file a written statement saying what you've spent and how much interest needs to be paid.The Transitional Assistance Department offers a variety of Self-Service options to help you save time and give you access to services on the go. Attach copies of your pay stubs for the last two months and proof of any other income. The request is to modify a judgment or permanent orders for child custody, visitation, or child support. a. Date: (TYPE OR PRINT NAME). Applicants shall fill out this form and submit payment to: SBMWD Customer Service for payment at 1350 "E" Street, San Bernardino, CA 92408. Applicants shall fill out this form and submit payment to: SBMWD Customer Service for payment at 1350 "E" Street, San Bernardino, CA 92408. Existing loan balance) that would assist the Assessor in the valuation of your property. Join the San Bernardino County Team!