Sample Forms, Policies, and Contracts. Sample Form of Payoff Letter.Step 2: Format your letter​​ Next, include a paragraph that states your account number, address and phone number. Provide a clear explanation: Your letter should acknowledge and indicate why something happened. This is an example of a payoff letter used in a syndicated loan transaction. This payoff letter (including the defined terms such as Lenders,. Interest must be collected to cover the days between the last applied monthly payment and the loan payoff date. An auto loan payoff quote, sometimes called a 10day payoff, states how much you need to pay off the loan balance. The loan payoff statement includes your principal balance, any outstanding interest due, and potentially any prepayment penalty (if applicable). Basic Payoff Calculation Example.