Our standard practice is to obtain written authorization from the borrower to provide a payoff quote to the title company. Download third-party Authorization form here.Note: By requesting a Payoff Statement you may incur a fee. Payoff Request Form. A lender's payoff statement or letter will show the amount you need to pay to completely close out the loan. The mortgage payoff statement is a document that provides a comprehensive breakdown of the remaining balance on a mortgage. In the formula, B stands for the payoff balance due in dollars. L is the total loan amount in dollars. This is an example of a payoff letter used in a syndicated loan transaction. This payoff letter (including the defined terms such as Lenders,.