Name of Mortgage Servicer. 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. ORIGINAL LOAN AMOUNT: This is an Adjustable Rate Mortgage. Payoff Statement Form. Mortgage Servicing, July 27, 2021 ; Mortgage Company: Required Disclosure – Specific Notice to Mortgage Applicant (7 TAC §56.200(b)). You can also request a payoff statement. Log in to Online Banking or use the mobile app.