1234, Main Street
Boston, MA 02123
04 April, 2005
<Recipient Address Goes Here>
Re: Account No. <number>
ATM Card No. <number>
On <date>, while I was conducting business at your ATM located at <address of ATM>, my bank card got stuck in the machine and I was unable to get it out. Because the lobby of the bank was closed at the time, no one was available to assist me. Please see that my card is returned to me at once or that a new one is issued and the old one is promptly destroyed.
Thank you for your immediate assistance.
encl: <List of enclosed items goes here>