Creating a payoff letter is essential to any loan or mortgage repayment process. Our free templates and this guide can help you get started.Please accept this as my authorization to issue a payoff statement to. Through an effective date of . A payoff statement should include the name and address of the lender preparing the statement and be addressed to the lender that requested the payoff. A Payoff Request Form is an essential document for those looking to fulfill the remaining balance on a home equity line of credit. Bank statement within the last 30 days with a Collin County address. Pay stubs within the last 30 days with a Collin County address. Recent bank and investment statements. Autopay with ACH: Complete our ACH form or call us to request a form.