This is a sample form of payoff letter. Members-only access., for the payoff of the above-referenced loan. This is an example of a payoff letter used in a syndicated loan transaction. This payoff letter (including the defined terms such as Lenders,. Create a Loan Payoff Letter online and download it as a PDF or Word document. Customize and print a blank Loan Payoff Letter for free. 504. Payoff of first mortgage loan. 103. Settlement charges to borrower (line 1400). 403. 108. Assessments. 408. A copy of the Good Faith Estimate or estimated settlement statement from the lender.