Request for payment plan

1234, Main Street
Boston, MA 02123

04 April, 2005

<Recipient Address Goes Here>

Hello,

Re: Account No. <account number>

I understand that the above-referenced account is <delinquent/past due>. I am writing to let you know that I have every intention of repaying this debt and would appreciate it if we could work out a payment plan which will bring this account current. Please contact me at your earliest convenience to make arrangements for a payment plan. I can be reached at <phone number>.

Thank you for your understanding and assistance in this matter.

Regards,

Robert Anderson

encl: <List of enclosed items goes here>

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