Free Request for Payment

This Request for Payment is from a creditor to a debtor and requests that payment be made immediately. This request identifies the parties, the amount of payment and what the payment is for. This Request for Payment also sets out what legal remedies will be taken is payment is not received.

Disclaimer:This was not drafted by an attorney & should not be used as a legal document.


Date: __________________

To: ______________________

Dear ______________________,

This is to notify you that you are currently indebted to us in the amount of $ __________________ for _______________________________________________.

We request you to make payments in full within ten (10) days of the date of this letter. If you fail, we reserve the right to institute legal proceedings against you to recover the above amount, together with interest and legal expenses. Since it would be in your best interest to resolve this matter before such action becomes necessary.

Kindly govern yourself accordingly.


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