1234, Main Street
Boston, MA 02123
04 April, 2005
<Recipient Address Goes Here>
Re: Account No. <account number>
Please be advised that the above-referenced account is now <number of days> days past due. Despite repeated requests for payment, we have not heard from you. Therefore, we are writing to inform you that if payment of the past due amount, <$amount> is not received within <days allowed> days of the date of this notice, a negative report will be made to <name of credit agency> indicating that this account has become delinquent.
In order to protect your good credit rating, please mail your payment immediately. If you are unable to make payment at this time, please notify us so that a payment schedule or other arrangement can be made.
Thank you for your immediate attention to this situation. We look forward to hearing from you.
encl: <List of enclosed items goes here>