For an official statement verifying your existing mortgage balance, monthly payments, and any late payments, please complete a 3rd Party Authorization form. Name of Mortgage Servicer.Most courts have a form called the "Statement of Inability to Pay" that you can fill out to show your financial situation. A person transmitting a payoff statement is considered the mortgage servicer for the mortgage described in the payoff statement. Use Fill to complete blank online TEXAS REAL ESTATE CONTRACTS pdf forms for free. You can also request a payoff statement. Why does my billing statement show multiple payments due?