Please include a per diem amount in the statement. Payoff Request Form.Pay.gov is a free service that allows you to pay many, but not all, United States government agencies. Find the form you have been directed to use below. We highly recommend that you complete your FAFSA no later than May 1st for the fall semester and no later than October 1st for the spring semester. Edit, sign, and share Seller Information and Mortgage Payoff Request Form online.