A secured lender shall prepare and deliver a payoff demand statement to the person who has requested it within fourteen days after receipt of the demand. This form is furnished to give you a statement of actual settlement costs.Under the Loan Information section, you will find a payoff request option that will take you to our payoff request form. Do you need a loan payoff request form? For an official statement verifying your existing mortgage balance, monthly payments, and any late payments, please complete a 3rd Party Authorization form. Third Party Payoff Request Form. All third-party payoff requests require prior authorization. Click on Payments and then click on Request Payoff. Filling out this form is straightforward. If you want to know what it will take to pay off a loan, you'll need to access a payoff statement (sometimes called a payoff letter).