(h) A secured creditor must provide upon request one payoff statement or one short‑pay statement without charge during any six‑month period. A mortgage payoff letter can come in two forms.One form tells borrowers the remaining principal amount and interest they have to pay to close out the loan. The ALTA Settlement Statement is a form that outlines all the expenditures and credits connected to a property deal. Loan payoff statements tell borrowers how much they must pay to close out a loan. Due to interest, etc. If so, include the date loan was issued, lender (lien holder) and address (just use whatever is on your statement). If you are the borrower requesting the payoff, please complete the form below. (f) A payoff statement or a short-pay statement may contain the amount of any fees authorized under this section not included in the payoff amount. Filling out this form is straightforward.