A payoff agreement is an informal contract in which a creditor agrees to accept the balance of a debt owed as full payment. The letter is to request a payoff on my account good through (date) _______________.My Loan number is _____________________. Do you have questions? Made out for the account as of December 31. Do you have questions? Request a Payoff Statement. P.O. Box 45046 Salt Lake City, UT 84145. Direct Deposit Form: Click here to download the PDF. Letter Mortgage Sample.