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. If you need a template, click here to download borrower authorization template. 20 MB max file size. If you need a template, click here to download borrower authorization template. 20 MB max file size. If you want to know what it will take to pay off a loan, you'll need to access a payoff statement (sometimes called a payoff letter). The letter outlines the acceptable methods of payment, such as checks, money orders, bank transfers, or credit cards. Request. Complete the form below to create a new request.