This form is furnished to give you a statement of actual settlement costs. A lender's payoff statement or letter will show the amount you need to pay to completely close out the loan.Request for a Payoff Statement. POST-CLOSING ESCROWS. To authorize Associated Bank to provide a written payoff statement and to close the account to any future advances if it is a revolving line of credit. A 10 day payoff is crucial to getting your old loans paid off during a refinance. Learn how it works from start to finish. HUD-1: A settlement statement listing all the closing costs for loans taken out before October 3, 2015. For mortgages after that date, see Closing Disclosure. Minnesota Gift Letter for Mortgage Template.