Edu for a Payoff Request. A lender's payoff statement or letter will show the amount you need to pay to completely close out the loan.A payoff statement should include the name and address of the lender preparing the statement and be addressed to the lender that requested the payoff. This form is furnished to give you a statement of actual settlement costs. This form is furnished to give you a statement of actual settlement costs. Do you need a loan payoff request form? 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). Edit, sign, and share sample payoff letter for private mortgage online. No need to install software, just go to DocHub, and sign up instantly and for free. This is the easiest way to electronically fill out the forms and prevent losing any information that you've entered.