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.Fill Online, Printable, Fillable, Blank PAYOFF STATEMENT FORM (Texas Real Estate Contracts) Form. What is a Payoff Agreement? A payoff agreement is an informal contract in which a creditor agrees to accept the balance of a debt owed as full payment. Click here for Instructions and an Affidavit form for a Request for Written Statement. The Clerk's office will fill in the Cause Number when you file this form. El Secretario del Tribunal anotará el Número de Caso cuando usted presente este. Simply fill out the Escrow Account Set Up Request Form. DHI Mortgage Company, Ltd.