View a Sample Settlement Statement to learn more about what to expect at settlement and to familiarize yourself with the language and terms of settlement. Payoff requests, including borrower's authorization, should be directed to the servicer of the first mortgage.Do you need a loan payoff request form? This form is furnished to give you a statement of actual settlement costs. Here are a few tips for completing the form: The form asks you to describe the property you wish to have released from garnishment. Maryland Mortgage Lender License 19468. Current Unpaid Principal Balance. A payoff statement or a mortgage payoff letter will typically show the balance you must pay in order to close your loan. This form is a statement of final loan terms and closing costs.