This is a sample Florida mortgage payoff authorization form and should not be used or relied upon for any real estate transaction. Edit, sign, and share sample payoff letter for private mortgage online.No need to install software, just go to DocHub, and sign up instantly and for free. We request you furnish our office a written payoff with per diem, please fax the payoff as soon as possible to (352)282-4895. This form is furnished to give you a statement of actual settlement costs. This estoppel letter MUST be sent within 14 days of the request or there is a risk of sanctions, including monetary penalties. How to fill out the Mortgage Payoff Statement Request Form? In this scenario, don't give up. Review your old explanation for anything you might have accidentally left out. This office is conducting a closing on the above referenced property on which you hold a mortgage.