Printable Business Form Templates
Payment Inquiry Business Form Template


To: {Name}
      {City, State, Zip}

Dear {Recipient},

We are writing to express our concern over your current account balance with {company name}. Your account is overdue in the amount of {amount}, which was due on {date}.

We have written you {number} times now to request payment on this account. Please indicate below what you intend to do with the account, and return that portion to us. Thank you for your cooperation.




Please select one:

_____   I will pay this account on or before _________
_____   I have enclosed payment in the amount of ________
_____   I have not paid this account because ______________

______________________________________            ______________________________________
Printed Name                                                                  Signature

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