Payoff Request Form. First name, Last name, Account Number (optional), Phone, Street address, Apartment, suite, etc.Arrange for payoff of loans. The seller should advise its bank of the projected closing date and request a pay-off letter. "Payoff amount" is generally higher than the remaining balance on the home. The mortgage payoff statement is a document that provides a comprehensive breakdown of the remaining balance on a mortgage. Filling out this form is straightforward. Fill out the form below to request a loan payoff letter. If you have any questions, please contact Loan Customer Service at 1-800-677-6272 option 5, option 2. The payoff letter should say upon payment they will record a satisfaction of lien.