Include your case number, the date of the payoff and your email address in your request. We will email the payoff statement to you upon receiving your request.Signature of Third Party. 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. This form is furnished to give you a statement of actual settlement costs. This form is furnished to give you a statement of actual settlement costs. This is a sample Florida mortgage payoff authorization form and should not be used or relied upon for any real estate transaction. The FDIC may be able to assist you in obtaining a lien release if the request is for a customer of a failed bank that was placed into FDIC receivership. Mortgage lenders ask for a letter of explanation to better understand your finances when determining whether to approve you for a loan.