Request for replacement bank card

1234, Main Street
Boston, MA 02123

04 April, 2005

<Recipient Address Goes Here>

Hello,

Re: Account No. <number>

I recently lost or misplaced my <type of card> card on the above-referenced account. The lost card bore the number <number from card>. I am writing to ask that you cancel that card and issue me a replacement card as soon as possible. No further use of this card should be authorized under any circumstances.

I appreciate your prompt attention to this request. If you have any questions concerning this, please do not hesitate to contact me.

Regards,

Robert Anderson

encl: <List of enclosed items goes here>

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