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. Do you need a loan payoff request form?To request a payoff quote, please complete the payoff quote form. This form is intended for 3rd parties acting on behalf of Mr. Cooper customers. Looking for a payoff amount? Taxpayers could be asked to provide a complete written Financial Statement. Alternatively, your lender may have a form you must fill out. 1. Enter the lender's name and loan account number.