1234, Main Street
Boston, MA 02123
04 April, 2005
<Recipient Address Goes Here>
Re: Collections Account No. <account number>
Enclosed please find my check number <check number> in the amount of <$amount> representing partial payment on the above-referenced account. According to our agreement, I will be making <number of payments> additional payments of <$amounts> each, until this account is paid in full.
Thank you for your assistance in this matter.
encl: <List of enclosed items goes here>