1234, Main Street
Boston, MA 02123
04 April, 2005
<Recipient Address Goes Here>
Re: Account No. <account number>
Please be advised that this account is now <number of days> days past due. Please remit a payment of <$amount> immediately to prevent this account from becoming delinquent. If we have not received payment from you within <number of days> days from the date of this notice, we will be forced to pursue other means of collecting on this debt.
If there is some reason why you are unable to make a payment at this time, please contact us immediately so that a payment schedule or other arrangement can be made.
Thank you for your immediate attention to this request.
encl: <List of enclosed items goes here>