PAYMENT INFORMATION REQUEST
Date:
___________________
Company: ___________________________
Name: ___________________________
Address: ___________________________
___________________________
Upon reviewing your account we have noticed that our
efforts have been unsuccessful in handling the development of payment
arrangements with you on the remainder of your past due balance.
We appreciate your business and would like to
expedite the solution to this problem as soon as possible. My office hours are______________________
please call me during those hours so we can discuss this matter.
Our records show your current past due amount as
_____________________________ ($________).
__________________________________
Account Representative
