Please complete all applicable fields below. Complete the form to request a reinstatement or payoff.To respond, you should answer each issue from the Complaint, assert your affirmative defenses, and file the Answer document with the court. Payoff Request Letter. I certify that all information contained within this renewal application is complete and true. Your account number is at the top of your monthly statement and on the payment coupon at the bottom of the statement. Online. In order for me to receive a payoff statement. I understand that the payoff statement will be sent within 5 business days of my complete request. Cost of the vehicle including trade-in, pay-off of trade-in, extended warranty, insurance, etc. 2.