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.A lender's payoff statement or letter will show the amount you need to pay to completely close out the loan. Do you need a loan payoff request form? Download third-party Authorization form here. Note: By requesting a Payoff Statement you may incur a fee. For an official statement verifying your existing mortgage balance, monthly payments, and any late payments, please complete a 3rd Party Authorization form. Do you need a loan payoff request form? Click on Payments and then click on Request Payoff. For an official statement verifying your existing mortgage balance, monthly payments, and any late payments, please complete a 3rd Party Authorization form.