One form tells borrowers the remaining principal amount and interest they have to pay to close out the loan. Do you need a loan payoff request form?Complete the form below to submit your payoff request. This form is furnished to give you a statement of actual settlement costs. Payoff Request Form. • Request for Mortgage Payoff Letter(s) (if applicable): Must be filled out completely. 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). Forms to make application for initial license to transact business as a Deferred Presentment Services Provider in Michigan. Payoff of first mortgage loan. 103.