Date

Name
Address
City, State, Zip
Creditor name
Address
City, State, Zip
Sent Certified Mail #0000000000000000000000
RE ACC#
To Whom It May Concern:
(Example)
I am writing today to inform you that I can no longer afford to pay my bill at the interest rates that
you are charging. I am a _________ and have lost my income for the summer and my wife
recently has lost her job.
Also, please read and honor the request below;
1. Federal Fair Debt Collection Practices Act
Under the Federal Fair Debt Collection Practices Act, if I, the debtor, request that a creditor stop
calling me at home or at work, and I make such request in writing, then the creditor must comply.

2. Written Request to Stop Calling

Sincerely,