This form is furnished to give you a statement of actual settlement costs. Payoff requests are answered within 1-2 days when received on the Download this pdf file.State Home Mortgage Official Payoff Request form. A lender's payoff statement or letter will show the amount you need to pay to completely close out the loan. 1. Payoff statements should always be addressed to your firm or title agency. A statement addressed to an employee or just a fax number is not sufficient. Do you need a loan payoff request form? This is an example of a payoff letter used in a syndicated loan transaction. This payoff letter (including the defined terms such as Lenders,. Learn what a mortgage payoff statement is, how to request one, and and what to do if your mortgage servicer fails to send it.