1234, Main Street
Boston, MA 02123
04 April, 2005
<Recipient Address Goes Here>
Re: Request for Copy of Check
Account No. <number>
I would appreciate it if you would please provide me with a copy of a canceled check on this account. I am interested in check number <check number>, which was made payable on <date> to <name of payee> in the amount of <$amount>. Please make sure that the copy you provide shows both the front and back of the canceled check.
Thank you for your prompt attention to this request. If you have any questions, please do not hesitate to contact me.
encl: <List of enclosed items goes here>