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PAYMENT INFORMATION REQUEST

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

 



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