The letter is to request a payoff on my account good through (date) _______________. My Loan number is _____________________.Please accept this as my authorization to issue a payoff statement to. Through an effective date of . 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. Do you have questions? Do you have questions? Letter Mortgage Sample. This document serves to release both the lender and borrower of their obligatory roles set forth in the original loan agreement.