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Mortgage Payoff Statement Request Form Template

Streamline Your Mortgage Payoff Process Effortlessly

Are you tired of confusing mortgage paperwork and delays? This Mortgage Payoff Statement Request Form Template is designed for homeowners like you, making it easier to request a payoff statement from your lender. You'll save time, enjoy a clear process, and increase your chances of a swift response while maintaining compliance with WCAG guidelines. Customize it to fit your needs and start using it right away-simply check out the live template now!

Use this Template (FREE) Live Preview
Your role in this request
Company or organization name (if applicable)
Your full name
Your email address
Your phone number
Preferred contact method
Email
Phone
Either
Borrower full name (as it appears on the loan)
Co-borrower full name (if applicable)
Last 4 digits of borrower SSN/Tax ID
Property address (include street, city, state/province, postal code, and country)
Mortgage servicer or lender name
Loan number (if known)
Is this a first mortgage or a subordinate lien?
First mortgage
Second mortgage or HELOC
Other or unsure
Type of payoff statement requested
Standard payoff statement
Updated payoff statement
HELOC payoff and account closure
Other
Please Specify:
Intended payoff date (good-through date requested)
Reason for requesting the payoff statement
Home sale or closing
Refinance
Paying off from personal funds
Loan modification or assumption
Divorce or estate matter
Other
Please Specify:
Special instructions (optional)
I authorize any applicable payoff statement fee charged by the servicer
Yes
No
Who should receive the payoff statement?
Borrower (requestor)
Co-borrower
Settlement or title company
Attorney
Real estate agent or broker
Other recipient
Primary recipient email for the payoff statement
Additional recipient email (optional)
Fax number for delivery (if fax is required)
Mailing address for delivery (if mail is required)
Preferred delivery method
Secure email (PDF)
Fax
Postal mail
Secure portal link (if available)
No preference
I am authorized to request and receive the payoff statement for this loan
Yes
No
If you are an authorized third party, date of written borrower consent
I consent to receive documents electronically related to this request
Yes
No
Signature
Signed on
I acknowledge the payoff amount may change due to daily interest and fees until the good-through date
Yes
No
Anything else we should know? (optional)
{"name":"Your role in this request", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Your role in this request, Company or organization name (if applicable), Your full name","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
paper art illustration related to mortgage payoff statement request form template and FormCreatorAI

When to use this form

Use this request when you need an exact payoff to sell your home, refinance, or pay off your loan early. It helps homeowners, sellers, buyers agents, and title or escrow teams get a written payoff with a good-through date, per-diem interest, fees, and wire instructions. Typical scenarios include listing your home and scheduling closing, switching servicers during a refinance, closing a HELOC, or handling an estate. If you are applying for a new mortgage at the same time, your lender may also ask for the Mortgage form. The outcome: you receive a clear payoff letter and delivery options so funds post on time and the lien releases without delays.

Must Ask Mortgage Payoff Statement Request Questions

  1. What is your loan number, property address, and the names on the loan?

    These identifiers match your request to the correct account and lien. They prevent delays and help the servicer pull the right figures the first time.

  2. What payoff good-through date do you need?

    Interest accrues daily, so your total changes each day. A target date ensures accurate per-diem interest and avoids a shortfall at closing.

  3. What is the purpose of the payoff (sale, refinance, early payoff, HELOC closure, estate)?

    Purpose guides who receives the letter, what fees apply, and any extra documents required. For a refinance, your new lender may also ask you to complete the Credit application form, and for business-owned property they may request the Commercial credit application form.

  4. Do you authorize us to share payoff details with your settlement or closing agent?

    Many servicers require written permission before sending figures to third parties. Clear authorization and contacts ensure the right team gets the letter by secure email, fax, or portal without resends.

  5. How will you send the payoff funds (wire, cashiers check, internal transfer)?

    Funding method affects timing, fees, and the payoff total shown. Knowing this lets the servicer include wire fees and provide correct instructions and cut-off times.

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